| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,143 |
3,991 |
$286K |
| 99199 |
Unlisted special service, procedure or report |
49,753 |
24,413 |
$230K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
511 |
416 |
$9K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
136 |
85 |
$8K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
34 |
17 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
29 |
14 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
63 |
30 |
$819.54 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
14 |
14 |
$347.65 |
| 90686 |
|
72 |
57 |
$262.83 |
| 99173 |
|
271 |
253 |
$70.42 |
| 92551 |
|
211 |
200 |
$33.68 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
56 |
33 |
$0.00 |