| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90686 |
|
1,085 |
1,084 |
$0.00 |
| 94760 |
|
12,735 |
11,597 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,453 |
1,449 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
11,776 |
10,673 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,749 |
1,712 |
$0.00 |
| 92551 |
|
2,428 |
2,423 |
$0.00 |
| 90651 |
|
102 |
102 |
$0.00 |
| 90744 |
|
51 |
50 |
$0.00 |
| 99000 |
|
1,630 |
1,561 |
$0.00 |
| 90698 |
|
142 |
141 |
$0.00 |
| 96127 |
|
88 |
88 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
266 |
265 |
$0.00 |
| 3074F |
|
245 |
245 |
$0.00 |
| 91307 |
|
30 |
30 |
$0.00 |
| 90619 |
|
54 |
54 |
$0.00 |
| 90656 |
|
55 |
55 |
$0.00 |
| 99174 |
|
31 |
30 |
$0.00 |
| 90680 |
|
13 |
13 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,161 |
1,153 |
$0.00 |
| 81002 |
|
3,993 |
3,943 |
$0.00 |
| 99173 |
|
2,465 |
2,459 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,930 |
2,825 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
330 |
321 |
$0.00 |
| 90461 |
|
1,155 |
1,148 |
$0.00 |
| 90633 |
|
136 |
135 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
64 |
62 |
$0.00 |
| 3078F |
|
244 |
244 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
869 |
869 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
130 |
130 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
493 |
493 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
29 |
29 |
$0.00 |
| 90670 |
|
252 |
251 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
92 |
92 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
109 |
107 |
$0.00 |
| 90649 |
|
131 |
131 |
$0.00 |
| 90710 |
|
56 |
54 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
128 |
122 |
$0.00 |
| 90734 |
|
67 |
67 |
$0.00 |
| 90715 |
|
27 |
27 |
$0.00 |