| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,406 |
3,092 |
$239K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,894 |
1,748 |
$148K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
991 |
991 |
$83K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
767 |
766 |
$62K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,324 |
2,316 |
$59K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
806 |
797 |
$56K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
2,120 |
2,118 |
$22K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
212 |
212 |
$18K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
56 |
56 |
$617.32 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
24 |
12 |
$301.62 |
| 90671 |
|
13 |
13 |
$0.00 |
| 90461 |
|
1,175 |
1,173 |
$0.00 |
| 90670 |
|
303 |
303 |
$0.00 |
| 90633 |
|
26 |
26 |
$0.00 |
| 90672 |
|
92 |
92 |
$0.00 |
| 90681 |
|
25 |
25 |
$0.00 |
| 90700 |
|
14 |
14 |
$0.00 |
| 90707 |
|
27 |
27 |
$0.00 |
| 90716 |
|
25 |
25 |
$0.00 |
| 90698 |
|
104 |
104 |
$0.00 |
| 90651 |
|
13 |
13 |
$0.00 |
| 90686 |
|
101 |
101 |
$0.00 |
| 90660 |
|
16 |
16 |
$0.00 |
| 90744 |
|
12 |
12 |
$0.00 |