| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
790 |
612 |
$55K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
622 |
581 |
$32K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
352 |
320 |
$28K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
310 |
279 |
$24K |
| 90670 |
|
335 |
292 |
$6K |
| 90697 |
|
150 |
148 |
$3K |
| 90686 |
|
131 |
130 |
$2K |
| 90680 |
|
131 |
108 |
$2K |
| 90677 |
|
93 |
77 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
92 |
79 |
$1K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
26 |
26 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$1K |
| 90656 |
|
41 |
41 |
$692.11 |
| 90633 |
|
27 |
27 |
$455.67 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
28 |
27 |
$430.79 |
| 81002 |
|
128 |
116 |
$334.70 |
| 90619 |
|
12 |
12 |
$203.02 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
314 |
251 |
$0.00 |
| 90461 |
|
25 |
24 |
$0.00 |