| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,069 |
1,840 |
$76K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
3,400 |
1,348 |
$41K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
482 |
481 |
$39K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
381 |
378 |
$30K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
73 |
72 |
$6K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
36 |
36 |
$3K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
289 |
289 |
$2K |
| 90461 |
|
828 |
733 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
82 |
41 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
26 |
25 |
$347.25 |
| 90680 |
|
152 |
152 |
$0.00 |
| 90686 |
|
317 |
317 |
$0.00 |
| 90677 |
|
224 |
223 |
$0.00 |
| 90651 |
|
12 |
12 |
$0.00 |
| 90670 |
|
195 |
194 |
$0.00 |
| 90648 |
|
74 |
74 |
$0.00 |
| 90633 |
|
28 |
27 |
$0.00 |