| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,840 |
2,239 |
$153K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
720 |
557 |
$35K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
765 |
726 |
$14K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
71 |
70 |
$10K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
81 |
81 |
$9K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
47 |
47 |
$5K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,206 |
1,157 |
$3K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
418 |
208 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
54 |
45 |
$392.36 |
| 81002 |
|
303 |
279 |
$110.50 |
| 36415 |
Collection of venous blood by venipuncture |
42 |
40 |
$60.00 |
| 99173 |
|
281 |
272 |
$0.00 |
| 90461 |
|
76 |
73 |
$0.00 |
| 92552 |
|
18 |
17 |
$0.00 |
| 90686 |
|
144 |
121 |
$0.00 |
| 99174 |
|
13 |
13 |
$0.00 |