| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,229 |
1,770 |
$116K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
569 |
534 |
$26K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
197 |
188 |
$16K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,121 |
1,021 |
$11K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
110 |
96 |
$9K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
101 |
88 |
$8K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
690 |
293 |
$6K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
672 |
624 |
$4K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
46 |
43 |
$4K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
82 |
82 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$1K |
| 87807 |
|
150 |
130 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
12 |
12 |
$381.69 |
| 92558 |
|
72 |
61 |
$63.90 |
| 99177 |
|
81 |
69 |
$63.00 |
| 96127 |
|
14 |
14 |
$52.50 |
| 96160 |
|
14 |
14 |
$46.76 |
| 90686 |
|
180 |
175 |
$0.00 |