| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,050 |
938 |
$39K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
140 |
138 |
$13K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
141 |
138 |
$12K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,292 |
597 |
$12K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
123 |
117 |
$11K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
107 |
103 |
$8K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
593 |
532 |
$4K |
| 90461 |
|
220 |
201 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
102 |
51 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
17 |
17 |
$976.33 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
36 |
36 |
$970.22 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
61 |
61 |
$715.96 |
| 90686 |
|
182 |
172 |
$0.16 |
| 90670 |
|
114 |
114 |
$0.00 |
| 90710 |
|
13 |
13 |
$0.00 |
| 90648 |
|
78 |
77 |
$0.00 |
| 90680 |
|
77 |
77 |
$0.00 |
| 96161 |
|
82 |
80 |
$0.00 |
| 90723 |
|
50 |
50 |
$0.00 |
| 90698 |
|
13 |
13 |
$0.00 |