| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,053 |
945 |
$63K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,103 |
1,098 |
$34K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
239 |
215 |
$21K |
| 92587 |
|
711 |
711 |
$13K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
105 |
105 |
$8K |
| 99441 |
|
115 |
106 |
$4K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
57 |
57 |
$4K |
| 90461 |
|
41 |
41 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
396 |
396 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
152 |
141 |
$1K |
| 90686 |
|
510 |
510 |
$124.95 |
| 81002 |
|
13 |
13 |
$1.74 |
| 99174 |
|
150 |
150 |
$0.00 |
| 99177 |
|
79 |
79 |
$0.00 |