| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
195 |
195 |
$19K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
469 |
438 |
$17K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
180 |
179 |
$16K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
217 |
205 |
$13K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
132 |
125 |
$12K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
68 |
67 |
$6K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
484 |
469 |
$2K |
| 97802 |
|
136 |
133 |
$915.00 |
| 90686 |
|
132 |
128 |
$280.25 |
| 81002 |
|
397 |
384 |
$194.37 |
| 85018 |
|
442 |
437 |
$168.48 |
| 90698 |
|
52 |
49 |
$120.05 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
42 |
42 |
$59.52 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
14 |
14 |
$19.86 |
| 99173 |
|
184 |
177 |
$0.00 |
| 90707 |
|
14 |
14 |
$0.00 |
| 90670 |
|
49 |
46 |
$0.00 |
| 90633 |
|
14 |
13 |
$0.00 |