| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,455 |
1,280 |
$94K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
325 |
303 |
$33K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
595 |
572 |
$9K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
63 |
63 |
$7K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
61 |
59 |
$7K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
455 |
425 |
$6K |
| 90461 |
|
101 |
99 |
$4K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
27 |
27 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
17 |
13 |
$1K |
| 90686 |
|
1,029 |
598 |
$1K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
15 |
15 |
$684.00 |
| 96127 |
|
106 |
80 |
$395.36 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
41 |
25 |
$298.30 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
15 |
15 |
$148.67 |
| 96160 |
|
79 |
79 |
$0.79 |
| 90674 |
|
13 |
13 |
$0.13 |