| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,124 |
2,538 |
$131K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,037 |
865 |
$70K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,777 |
1,045 |
$14K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
187 |
179 |
$12K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
212 |
198 |
$10K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
177 |
142 |
$8K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
102 |
97 |
$5K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,260 |
1,191 |
$4K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
183 |
165 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
52 |
44 |
$2K |
| 99406 |
|
58 |
54 |
$141.44 |
| 94760 |
|
65 |
53 |
$134.09 |
| 90662 |
|
12 |
12 |
$0.12 |
| 90686 |
|
112 |
104 |
$0.00 |
| 90680 |
|
14 |
12 |
$0.00 |
| 90698 |
|
43 |
39 |
$0.00 |
| 90656 |
|
19 |
15 |
$0.00 |
| 90670 |
|
87 |
77 |
$0.00 |
| 90633 |
|
91 |
88 |
$0.00 |
| 90734 |
|
16 |
14 |
$0.00 |