| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,705 |
1,540 |
$142K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
156 |
156 |
$14K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
105 |
105 |
$11K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
61 |
61 |
$5K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
520 |
510 |
$5K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
209 |
205 |
$3K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
218 |
218 |
$3K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
44 |
37 |
$2K |
| 99177 |
|
359 |
356 |
$1K |
| 87428 |
|
13 |
12 |
$503.97 |
| 92551 |
|
67 |
67 |
$452.33 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
17 |
17 |
$421.60 |