| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,188 |
1,158 |
$79K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
738 |
731 |
$37K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
369 |
352 |
$34K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
220 |
219 |
$21K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
223 |
214 |
$20K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
62 |
62 |
$6K |
| 99058 |
|
291 |
289 |
$5K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
336 |
334 |
$4K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
345 |
171 |
$4K |
| 99382 |
|
27 |
27 |
$3K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
25 |
25 |
$2K |
| 99383 |
|
12 |
12 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
29 |
29 |
$1K |
| 99401 |
|
35 |
35 |
$909.98 |
| 94760 |
|
196 |
182 |
$375.90 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
16 |
16 |
$113.81 |
| 85018 |
|
47 |
47 |
$90.34 |
| 90648 |
|
27 |
27 |
$0.00 |
| 90670 |
|
256 |
256 |
$0.00 |
| 90633 |
|
38 |
38 |
$0.00 |
| 99072 |
|
141 |
126 |
$0.00 |
| 90710 |
|
35 |
35 |
$0.00 |
| 90680 |
|
121 |
121 |
$0.00 |
| 90744 |
|
53 |
53 |
$0.00 |
| 90698 |
|
132 |
132 |
$0.00 |
| 90686 |
|
43 |
43 |
$0.00 |