| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,694 |
1,586 |
$112K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
501 |
465 |
$55K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
422 |
404 |
$8K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
25 |
25 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
13 |
13 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
13 |
13 |
$1K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
49 |
47 |
$1K |
| 99050 |
|
28 |
28 |
$854.46 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
45 |
41 |
$441.97 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
28 |
14 |
$349.96 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
13 |
12 |
$163.46 |
| 96127 |
|
30 |
25 |
$92.85 |
| 96160 |
|
12 |
12 |
$46.29 |
| 90686 |
|
12 |
12 |
$6.50 |