| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,539 |
1,445 |
$53K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
302 |
301 |
$23K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
225 |
223 |
$18K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
311 |
296 |
$15K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,691 |
615 |
$14K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
119 |
107 |
$8K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
493 |
476 |
$7K |
| 90461 |
|
282 |
224 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
13 |
13 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
117 |
117 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
70 |
34 |
$904.80 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
63 |
39 |
$504.03 |
| 96160 |
|
25 |
25 |
$54.85 |
| 1160F |
|
274 |
243 |
$0.00 |
| 1159F |
|
274 |
243 |
$0.00 |
| 90670 |
|
36 |
36 |
$0.00 |
| 3078F |
|
73 |
65 |
$0.00 |
| 90686 |
|
331 |
325 |
$0.00 |
| 3074F |
|
73 |
65 |
$0.00 |
| 3008F |
|
213 |
191 |
$0.00 |