| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,788 |
2,515 |
$108K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,138 |
494 |
$23K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
708 |
557 |
$22K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
175 |
158 |
$12K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
89 |
83 |
$5K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
340 |
242 |
$4K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
105 |
100 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
249 |
237 |
$3K |
| 99177 |
|
407 |
391 |
$3K |
| 92558 |
|
371 |
355 |
$2K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
238 |
209 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
28 |
26 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
109 |
109 |
$1K |
| 81002 |
|
205 |
197 |
$599.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
34 |
31 |
$489.86 |
| 85018 |
|
165 |
153 |
$374.75 |
| 81003 |
|
150 |
140 |
$304.27 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
16 |
15 |
$30.26 |
| 90670 |
|
79 |
72 |
$0.00 |
| 90648 |
|
35 |
32 |
$0.00 |
| 90686 |
|
176 |
171 |
$0.00 |
| 90723 |
|
18 |
15 |
$0.00 |