| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,771 |
3,188 |
$146K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,440 |
1,281 |
$54K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
658 |
578 |
$39K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
590 |
513 |
$37K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,437 |
1,160 |
$33K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
364 |
300 |
$22K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,290 |
556 |
$14K |
| 95115 |
|
1,371 |
786 |
$12K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,033 |
924 |
$12K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
153 |
123 |
$10K |
| 95117 |
|
594 |
287 |
$6K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
707 |
631 |
$6K |
| 92551 |
|
770 |
648 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
54 |
31 |
$4K |
| 96161 |
|
162 |
132 |
$2K |
| 96127 |
|
359 |
270 |
$2K |
| 87807 |
|
217 |
184 |
$2K |
| 81003 |
|
859 |
725 |
$2K |
| 85018 |
|
304 |
231 |
$638.18 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
48 |
40 |
$608.03 |
| 83655 |
|
45 |
37 |
$529.38 |
| 96160 |
|
37 |
28 |
$473.64 |
| 90670 |
|
493 |
446 |
$238.00 |
| 90686 |
|
467 |
403 |
$155.75 |
| 90723 |
|
239 |
214 |
$101.72 |
| 99173 |
|
417 |
316 |
$91.26 |
| 90633 |
|
87 |
74 |
$86.09 |
| 90685 |
|
33 |
30 |
$0.00 |
| 90681 |
|
25 |
24 |
$0.00 |
| 90710 |
|
42 |
31 |
$0.00 |
| 90647 |
|
298 |
266 |
$0.00 |