| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,316 |
2,192 |
$213K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
638 |
570 |
$87K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
732 |
727 |
$20K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
59 |
59 |
$9K |
| 90686 |
|
512 |
502 |
$8K |
| 90651 |
|
40 |
40 |
$8K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
41 |
41 |
$6K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
44 |
44 |
$5K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
172 |
172 |
$5K |
| 90734 |
|
26 |
26 |
$3K |
| 92551 |
|
231 |
230 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
103 |
101 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12 |
12 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
116 |
106 |
$2K |
| 96127 |
|
91 |
91 |
$715.63 |
| 99172 |
|
20 |
20 |
$320.00 |
| 80061 |
Lipid panel |
12 |
12 |
$214.32 |
| 85018 |
|
24 |
24 |
$76.08 |
| 99072 |
|
49 |
44 |
$0.00 |
| 99177 |
|
28 |
28 |
$0.00 |