| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
442 |
410 |
$22K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
99 |
93 |
$8K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
121 |
115 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
97 |
97 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
855 |
482 |
$802.56 |
| 90716 |
|
34 |
19 |
$348.64 |
| 90651 |
|
24 |
13 |
$287.54 |
| 90707 |
|
25 |
14 |
$184.98 |
| 90658 |
|
67 |
44 |
$86.46 |
| 90686 |
|
272 |
243 |
$43.20 |
| 90700 |
|
137 |
97 |
$29.31 |
| 99177 |
|
319 |
245 |
$19.45 |
| 92587 |
|
562 |
292 |
$0.00 |
| 3008F |
|
66 |
66 |
$0.00 |
| 90670 |
|
50 |
38 |
$0.00 |
| 90713 |
|
88 |
64 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
13 |
13 |
$0.00 |
| 90715 |
|
20 |
12 |
$0.00 |
| 90633 |
|
25 |
15 |
$0.00 |
| 90648 |
|
61 |
40 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
14 |
14 |
$0.00 |