| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,300 |
1,816 |
$127K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
350 |
316 |
$28K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
212 |
211 |
$16K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
755 |
740 |
$13K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
148 |
148 |
$11K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
86 |
76 |
$6K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$964.68 |
| 92551 |
|
112 |
111 |
$725.94 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
25 |
25 |
$239.20 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
30 |
27 |
$227.77 |
| 99051 |
|
32 |
32 |
$224.52 |
| 90686 |
|
157 |
155 |
$57.64 |
| 3074F |
|
157 |
122 |
$0.00 |
| 3078F |
|
156 |
123 |
$0.00 |
| 99173 |
|
56 |
54 |
$0.00 |
| 90685 |
|
12 |
12 |
$0.00 |