| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
674 |
631 |
$26K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
201 |
195 |
$10K |
| 86403 |
|
599 |
572 |
$3K |
| 87070 |
|
598 |
571 |
$2K |
| 87184 |
|
599 |
572 |
$1K |
| 92550 |
|
209 |
199 |
$1K |
| 92587 |
|
57 |
57 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
44 |
44 |
$1K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
51 |
51 |
$990.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
77 |
51 |
$988.30 |
| 92568 |
|
191 |
182 |
$854.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
13 |
13 |
$727.70 |
| 92551 |
|
58 |
58 |
$377.48 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
44 |
44 |
$100.60 |
| 96127 |
|
13 |
13 |
$22.05 |
| 99173 |
|
24 |
24 |
$13.72 |
| 85018 |
|
14 |
14 |
$13.65 |
| 97802 |
|
46 |
45 |
$0.00 |
| 92015 |
Determination of refractive state |
63 |
62 |
$0.00 |