| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,764 |
1,451 |
$67K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
247 |
246 |
$22K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
207 |
191 |
$18K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
207 |
206 |
$18K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
533 |
252 |
$8K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
945 |
401 |
$8K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
394 |
377 |
$6K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
41 |
41 |
$3K |
| 99429 |
|
65 |
65 |
$2K |
| 90461 |
|
238 |
201 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
206 |
162 |
$2K |
| 99215 |
Prolong outpt/office vis |
15 |
13 |
$1K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
31 |
31 |
$467.15 |
| 96160 |
|
244 |
220 |
$427.06 |
| 87807 |
|
23 |
22 |
$271.94 |
| 90651 |
|
69 |
62 |
$28.45 |
| 94760 |
|
20 |
16 |
$10.35 |
| 90680 |
|
13 |
13 |
$0.00 |
| 90716 |
|
13 |
13 |
$0.00 |
| 90686 |
|
39 |
39 |
$0.00 |
| 90670 |
|
95 |
94 |
$0.00 |
| 90648 |
|
17 |
16 |
$0.00 |
| 90734 |
|
14 |
14 |
$0.00 |
| 90707 |
|
12 |
12 |
$0.00 |