| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,328 |
1,987 |
$142K |
| 92552 |
|
472 |
452 |
$8K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
487 |
479 |
$6K |
| 36410 |
|
304 |
304 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
42 |
40 |
$3K |
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
14 |
14 |
$3K |
| 86580 |
|
329 |
329 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
257 |
256 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
26 |
26 |
$2K |
| 92567 |
|
127 |
118 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$1K |
| 81002 |
|
336 |
335 |
$551.96 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
32 |
32 |
$406.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
102 |
100 |
$367.50 |
| 90686 |
|
12 |
12 |
$57.75 |
| 90461 |
|
14 |
13 |
$29.72 |
| 69210 |
|
12 |
12 |
$0.00 |