| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,356 |
2,284 |
$104K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,102 |
918 |
$16K |
| 92587 |
|
864 |
739 |
$15K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
197 |
150 |
$9K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
355 |
258 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
134 |
98 |
$4K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
98 |
74 |
$2K |
| 90686 |
|
327 |
246 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
59 |
48 |
$2K |
| 90461 |
|
284 |
219 |
$1K |
| 99173 |
|
527 |
384 |
$1K |
| 99177 |
|
115 |
91 |
$709.75 |
| 92551 |
|
64 |
59 |
$696.21 |
| 96127 |
|
293 |
247 |
$693.87 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
14 |
13 |
$663.76 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
15 |
12 |
$585.23 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
28 |
19 |
$146.54 |
| 97802 |
|
22 |
22 |
$85.19 |