| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
501 |
481 |
$39K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
70 |
70 |
$8K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
414 |
412 |
$6K |
| 90461 |
|
183 |
183 |
$5K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
44 |
44 |
$5K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
42 |
39 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
60 |
56 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
14 |
14 |
$114.52 |
| 85018 |
|
42 |
42 |
$94.78 |
| 81003 |
|
38 |
37 |
$82.51 |
| 83655 |
|
13 |
13 |
$24.12 |
| 92552 |
|
192 |
192 |
$23.78 |
| 90686 |
|
190 |
190 |
$0.00 |
| 90698 |
|
14 |
14 |
$0.00 |
| 90633 |
|
13 |
13 |
$0.00 |
| 90670 |
|
12 |
12 |
$0.00 |