| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
147 |
139 |
$7K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
83 |
75 |
$6K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
56 |
52 |
$4K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
16 |
16 |
$1K |
| 90670 |
|
77 |
69 |
$1K |
| 99215 |
Prolong outpt/office vis |
19 |
14 |
$935.15 |
| 90698 |
|
65 |
57 |
$686.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
23 |
21 |
$672.95 |
| 90680 |
|
36 |
29 |
$396.18 |
| 90686 |
|
41 |
32 |
$257.14 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
15 |
14 |
$235.50 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
15 |
15 |
$225.65 |
| 90744 |
|
13 |
12 |
$135.48 |
| 90633 |
|
15 |
13 |
$128.03 |
| 90685 |
|
12 |
12 |
$76.80 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
16 |
12 |
$0.00 |