| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
659 |
628 |
$51K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
12 |
12 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12 |
12 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
137 |
137 |
$294.29 |
| 90686 |
|
25 |
25 |
$239.92 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
77 |
70 |
$138.16 |
| 99051 |
|
25 |
25 |
$74.71 |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
16 |
15 |
$0.00 |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
16 |
16 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
15 |
15 |
$0.00 |
| 90670 |
|
12 |
12 |
$0.00 |