| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,149 |
1,021 |
$42K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
529 |
227 |
$5K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
140 |
136 |
$1K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
14 |
14 |
$978.50 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12 |
12 |
$951.36 |
| 90461 |
|
37 |
31 |
$388.08 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
15 |
13 |
$361.40 |
| G8484 |
Influenza immunization was not administered, reason not given |
136 |
128 |
$0.00 |
| 90670 |
|
13 |
13 |
$0.00 |
| G8483 |
Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons) |
13 |
13 |
$0.00 |
| 90686 |
|
14 |
13 |
$0.00 |