| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,122 |
1,013 |
$63K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
229 |
213 |
$19K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
372 |
340 |
$5K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
38 |
38 |
$3K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
194 |
91 |
$3K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
28 |
27 |
$2K |
| 90686 |
|
102 |
102 |
$1K |
| 96127 |
|
221 |
212 |
$1K |
| 92551 |
|
111 |
111 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
16 |
16 |
$1K |
| 99174 |
|
125 |
125 |
$628.74 |
| 90670 |
|
27 |
27 |
$310.20 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
243 |
243 |
$242.55 |
| 90648 |
|
13 |
13 |
$149.60 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
16 |
16 |
$135.52 |
| 36415 |
Collection of venous blood by venipuncture |
38 |
38 |
$119.70 |
| 90461 |
|
48 |
48 |
$80.85 |
| 99000 |
|
379 |
355 |
$27.02 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
27 |
27 |
$23.10 |
| 36416 |
|
58 |
55 |
$9.90 |