| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,149 |
1,977 |
$96K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
927 |
789 |
$15K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
121 |
121 |
$8K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
69 |
68 |
$5K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
359 |
354 |
$5K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
73 |
73 |
$4K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,341 |
897 |
$3K |
| 92551 |
|
659 |
659 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
27 |
27 |
$2K |
| 90686 |
|
455 |
335 |
$1K |
| 90461 |
|
50 |
48 |
$946.51 |
| 36415 |
Collection of venous blood by venipuncture |
531 |
530 |
$888.32 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
12 |
12 |
$863.69 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
12 |
12 |
$654.27 |
| 96127 |
|
84 |
80 |
$287.89 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
22 |
22 |
$244.04 |
| 99173 |
|
15 |
15 |
$51.50 |
| 92587 |
|
623 |
326 |
$16.38 |
| 99177 |
|
57 |
48 |
$7.78 |
| 90658 |
|
20 |
13 |
$0.00 |
| 90648 |
|
72 |
39 |
$0.00 |
| 90713 |
|
62 |
37 |
$0.00 |
| 90700 |
|
121 |
68 |
$0.00 |
| 90670 |
|
104 |
55 |
$0.00 |
| 90633 |
|
26 |
13 |
$0.00 |
| 3008F |
|
16 |
12 |
$0.00 |