| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,148 |
1,700 |
$104K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
348 |
309 |
$25K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
835 |
766 |
$16K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
90 |
85 |
$7K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
48 |
45 |
$4K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
343 |
158 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
16 |
15 |
$1K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
13 |
12 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
149 |
139 |
$924.30 |
| 99177 |
|
456 |
398 |
$544.35 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
15 |
14 |
$519.85 |
| 90461 |
|
134 |
131 |
$372.78 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
34 |
34 |
$362.43 |
| 92587 |
|
233 |
202 |
$111.91 |
| 90674 |
|
70 |
66 |
$81.00 |
| 97802 |
|
321 |
283 |
$17.08 |
| 90686 |
|
13 |
12 |
$13.42 |
| 90658 |
|
17 |
17 |
$0.00 |
| 90700 |
|
12 |
12 |
$0.00 |