| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,112 |
979 |
$27K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
359 |
334 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
37 |
31 |
$2K |
| 92551 |
|
410 |
350 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
25 |
25 |
$2K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
103 |
94 |
$2K |
| 86318 |
|
84 |
70 |
$1K |
| 99173 |
|
514 |
439 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
118 |
52 |
$878.02 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
19 |
19 |
$471.24 |
| 90461 |
|
28 |
26 |
$324.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
14 |
13 |
$226.00 |
| 3008F |
|
399 |
333 |
$81.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
31 |
25 |
$58.72 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
100 |
87 |
$21.00 |
| 97802 |
|
38 |
29 |
$9.00 |