| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,077 |
3,935 |
$275K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,289 |
1,597 |
$153K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
3,174 |
2,263 |
$86K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,193 |
821 |
$74K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,184 |
945 |
$65K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,001 |
626 |
$61K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
249 |
158 |
$17K |
| 3008F |
|
2,382 |
1,491 |
$15K |
| 92551 |
|
2,011 |
1,260 |
$14K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
500 |
349 |
$14K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,808 |
1,196 |
$11K |
| 99174 |
|
683 |
485 |
$11K |
| 96127 |
|
1,331 |
797 |
$4K |
| 99173 |
|
2,002 |
1,256 |
$3K |
| 94760 |
|
2,622 |
1,830 |
$3K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
313 |
221 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
167 |
158 |
$2K |
| 81003 |
|
1,620 |
996 |
$2K |
| 96160 |
|
791 |
510 |
$1K |
| 99383 |
|
14 |
14 |
$1K |
| 96161 |
|
1,014 |
776 |
$865.56 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
57 |
41 |
$672.13 |
| 94010 |
|
21 |
13 |
$498.31 |
| 94664 |
|
23 |
13 |
$234.41 |
| 90686 |
|
1,166 |
869 |
$19.58 |
| 90707 |
|
208 |
147 |
$0.00 |
| 90670 |
|
967 |
767 |
$0.00 |
| 90633 |
|
300 |
226 |
$0.00 |
| 90734 |
|
69 |
39 |
$0.00 |
| 99072 |
|
71 |
67 |
$0.00 |
| 90685 |
|
79 |
59 |
$0.00 |
| 90698 |
|
923 |
729 |
$0.00 |
| 90680 |
|
434 |
377 |
$0.00 |
| 90716 |
|
211 |
147 |
$0.00 |
| 2000F |
|
254 |
182 |
$0.00 |
| 90744 |
|
292 |
239 |
$0.00 |
| 90651 |
|
103 |
58 |
$0.00 |
| 2001F |
|
273 |
198 |
$0.00 |