| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,666 |
1,653 |
$103K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,553 |
1,473 |
$101K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
992 |
962 |
$95K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
907 |
824 |
$85K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
728 |
721 |
$72K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
297 |
297 |
$29K |
| 99058 |
|
1,017 |
974 |
$18K |
| 94010 |
|
220 |
214 |
$6K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
56 |
56 |
$6K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
283 |
281 |
$6K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
437 |
430 |
$4K |
| 92567 |
|
243 |
234 |
$3K |
| 83655 |
|
272 |
271 |
$3K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
44 |
38 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
299 |
295 |
$2K |
| 36416 |
|
461 |
458 |
$2K |
| 99460 |
|
20 |
17 |
$1K |
| 92015 |
Determination of refractive state |
711 |
705 |
$1K |
| 85018 |
|
313 |
312 |
$611.34 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
13 |
13 |
$515.87 |
| 92587 |
|
895 |
883 |
$490.37 |
| 96127 |
|
44 |
44 |
$199.12 |
| 90474 |
|
17 |
17 |
$182.77 |
| 99188 |
|
13 |
13 |
$154.98 |
| 81002 |
|
15 |
14 |
$33.86 |
| 90707 |
|
212 |
211 |
$0.00 |
| 90670 |
|
611 |
609 |
$0.00 |
| 90633 |
|
282 |
281 |
$0.00 |
| 90648 |
|
613 |
611 |
$0.00 |
| 90713 |
|
544 |
542 |
$0.00 |
| 90700 |
|
683 |
681 |
$0.00 |
| 90685 |
|
333 |
331 |
$0.00 |
| 90680 |
|
412 |
410 |
$0.00 |
| 90744 |
|
325 |
322 |
$0.00 |
| 90686 |
|
348 |
348 |
$0.00 |
| 90651 |
|
36 |
36 |
$0.00 |
| 90716 |
|
215 |
214 |
$0.00 |
| 99000 |
|
36 |
36 |
$0.00 |