| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
503 |
480 |
$40K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
171 |
171 |
$20K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
149 |
142 |
$17K |
| 90461 |
|
247 |
247 |
$8K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
411 |
411 |
$6K |
| 54150 |
|
56 |
56 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
27 |
27 |
$4K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
29 |
29 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
43 |
43 |
$652.09 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
26 |
26 |
$212.68 |
| 85018 |
|
73 |
73 |
$168.28 |
| 80061 |
Lipid panel |
12 |
12 |
$146.85 |
| 96160 |
|
14 |
14 |
$121.68 |
| 81003 |
|
13 |
13 |
$28.99 |
| 90698 |
|
118 |
118 |
$0.00 |
| 90686 |
|
87 |
87 |
$0.00 |
| 90744 |
|
14 |
14 |
$0.00 |
| 90680 |
|
14 |
14 |
$0.00 |
| 90670 |
|
123 |
123 |
$0.00 |
| 92552 |
|
195 |
195 |
$0.00 |