| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,055 |
964 |
$51K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
964 |
671 |
$11K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
227 |
220 |
$8K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
13 |
12 |
$747.89 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
16 |
14 |
$744.36 |
| 90686 |
|
51 |
51 |
$660.94 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
44 |
44 |
$642.93 |
| 92551 |
|
64 |
64 |
$592.92 |
| 92565 |
|
74 |
74 |
$416.02 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
38 |
37 |
$278.20 |
| 96127 |
|
69 |
69 |
$91.74 |
| 86580 |
|
12 |
12 |
$48.49 |
| 97802 |
|
197 |
197 |
$0.00 |