| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,529 |
1,377 |
$53K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
310 |
304 |
$23K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
408 |
394 |
$20K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
186 |
178 |
$13K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
161 |
157 |
$13K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,087 |
457 |
$8K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
89 |
86 |
$7K |
| 90461 |
|
344 |
280 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
210 |
142 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
28 |
13 |
$333.60 |
| 96160 |
|
65 |
63 |
$148.16 |
| 90474 |
|
12 |
12 |
$94.08 |
| 90670 |
|
79 |
77 |
$1.00 |
| 90648 |
|
39 |
39 |
$0.00 |
| 90633 |
|
27 |
27 |
$0.00 |
| 90734 |
|
14 |
14 |
$0.00 |
| 90686 |
|
45 |
45 |
$0.00 |