| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,035 |
2,737 |
$171K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
235 |
215 |
$17K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
153 |
148 |
$11K |
| 90686 |
|
472 |
460 |
$5K |
| 92551 |
|
553 |
540 |
$5K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,125 |
2,040 |
$4K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
51 |
49 |
$4K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
40 |
39 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
222 |
210 |
$3K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
188 |
91 |
$2K |
| 90670 |
|
82 |
81 |
$2K |
| 85013 |
|
784 |
755 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
134 |
128 |
$1K |
| 90461 |
|
399 |
389 |
$1K |
| 90698 |
|
26 |
26 |
$656.84 |
| 36416 |
|
838 |
810 |
$360.33 |
| 90685 |
|
28 |
28 |
$307.22 |
| 83655 |
|
17 |
16 |
$197.44 |
| 81003 |
|
69 |
64 |
$166.01 |
| 99174 |
|
26 |
26 |
$131.57 |
| 99173 |
|
17 |
17 |
$42.59 |