| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,154 |
4,770 |
$308K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,136 |
2,058 |
$179K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,358 |
1,355 |
$50K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
263 |
263 |
$22K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
243 |
243 |
$22K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
678 |
667 |
$19K |
| 99215 |
Prolong outpt/office vis |
154 |
153 |
$17K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
162 |
162 |
$14K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,646 |
1,640 |
$13K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
793 |
778 |
$11K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
315 |
315 |
$5K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
66 |
48 |
$1K |
| 87807 |
|
30 |
30 |
$376.20 |
| 96161 |
|
15 |
15 |
$75.00 |
| 96127 |
|
12 |
12 |
$47.52 |
| 99173 |
|
14 |
14 |
$33.67 |
| 36416 |
|
12 |
12 |
$29.64 |
| 96160 |
|
27 |
27 |
$0.00 |
| 90670 |
|
12 |
12 |
$0.00 |
| 90680 |
|
12 |
12 |
$0.00 |
| 90723 |
|
12 |
12 |
$0.00 |
| 90686 |
|
12 |
12 |
$0.00 |
| 90647 |
|
12 |
12 |
$0.00 |