| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
267 |
251 |
$10K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
179 |
167 |
$8K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
188 |
182 |
$4K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
72 |
70 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
32 |
32 |
$2K |
| 92551 |
|
128 |
128 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
28 |
28 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
13 |
13 |
$650.00 |
| 90686 |
|
95 |
93 |
$269.23 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
15 |
15 |
$196.02 |
| 90461 |
|
17 |
17 |
$190.00 |
| 96127 |
|
13 |
13 |
$39.26 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
21 |
17 |
$0.00 |
| 99173 |
|
131 |
129 |
$0.00 |
| 99072 |
|
15 |
15 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
15 |
12 |
$0.00 |