| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,576 |
1,350 |
$77K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
462 |
415 |
$22K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
224 |
214 |
$18K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
184 |
169 |
$13K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
170 |
155 |
$12K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
537 |
500 |
$4K |
| 96160 |
|
844 |
756 |
$4K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
111 |
99 |
$3K |
| 96127 |
|
421 |
369 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
129 |
116 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
131 |
60 |
$962.93 |
| 96161 |
|
99 |
89 |
$261.82 |
| 92551 |
|
26 |
21 |
$195.08 |
| 92558 |
|
32 |
24 |
$187.44 |
| 99177 |
|
12 |
12 |
$48.24 |
| 90461 |
|
312 |
292 |
$45.04 |
| 36415 |
Collection of venous blood by venipuncture |
18 |
16 |
$22.65 |
| 36416 |
|
12 |
12 |
$1.54 |
| 90677 |
|
93 |
90 |
$0.29 |
| 90698 |
|
107 |
104 |
$0.00 |
| 90680 |
|
12 |
12 |
$0.00 |