| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,863 |
1,680 |
$119K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
553 |
526 |
$48K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,034 |
1,010 |
$5K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
50 |
50 |
$5K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
117 |
111 |
$4K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
320 |
303 |
$3K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
307 |
302 |
$3K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
14 |
13 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$1K |
| 0071A |
|
18 |
18 |
$720.00 |
| 0072A |
|
16 |
16 |
$640.00 |
| 81002 |
|
174 |
174 |
$429.86 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
163 |
162 |
$193.23 |
| 90686 |
|
397 |
395 |
$0.00 |
| 99000 |
|
661 |
614 |
$0.00 |
| 91307 |
|
61 |
54 |
$0.00 |
| 99072 |
|
25 |
25 |
$0.00 |