| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
857 |
814 |
$31K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
417 |
398 |
$28K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
410 |
361 |
$26K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
515 |
484 |
$23K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
158 |
138 |
$10K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
15 |
15 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
69 |
46 |
$1K |
| 99460 |
|
13 |
13 |
$770.48 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
14 |
14 |
$203.34 |
| 92551 |
|
54 |
54 |
$166.48 |
| 96160 |
|
15 |
13 |
$50.90 |
| 99173 |
|
59 |
59 |
$39.98 |
| 96161 |
|
12 |
12 |
$29.09 |
| 90700 |
|
150 |
122 |
$0.00 |
| 90713 |
|
42 |
38 |
$0.00 |
| 90670 |
|
95 |
80 |
$0.00 |
| 90648 |
|
80 |
63 |
$0.00 |
| 90744 |
|
14 |
12 |
$0.00 |
| 90686 |
|
183 |
150 |
$0.00 |
| 94760 |
|
77 |
73 |
$0.00 |