| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
770 |
661 |
$29K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
230 |
212 |
$9K |
| 99199 |
Unlisted special service, procedure or report |
772 |
761 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
16 |
13 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
26 |
26 |
$621.72 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
40 |
34 |
$619.65 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
13 |
12 |
$490.80 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
27 |
24 |
$187.78 |
| 90688 |
|
39 |
32 |
$98.10 |
| 92551 |
|
30 |
26 |
$1.00 |
| 99173 |
|
30 |
26 |
$1.00 |