| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,738 |
5,155 |
$278K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,275 |
1,264 |
$29K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
2,869 |
2,845 |
$27K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
360 |
357 |
$19K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
307 |
307 |
$17K |
| 92587 |
|
607 |
607 |
$12K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
632 |
622 |
$9K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
154 |
154 |
$8K |
| 92558 |
|
898 |
885 |
$4K |
| 90461 |
|
166 |
166 |
$3K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
200 |
178 |
$2K |
| 0001A |
|
51 |
50 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
329 |
162 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
12 |
12 |
$921.48 |
| 87807 |
|
283 |
267 |
$880.38 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
82 |
82 |
$783.90 |
| 0072A |
|
19 |
19 |
$760.00 |
| 0002A |
|
19 |
19 |
$760.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
69 |
69 |
$737.36 |
| 99173 |
|
995 |
982 |
$674.81 |
| 90686 |
|
145 |
143 |
$390.59 |
| 90734 |
|
17 |
17 |
$267.78 |
| 90670 |
|
24 |
24 |
$226.43 |
| 90688 |
|
46 |
45 |
$70.33 |
| 3008F |
|
1,227 |
1,212 |
$5.00 |
| 99000 |
|
242 |
230 |
$0.00 |
| 91307 |
|
22 |
21 |
$0.00 |
| 99070 |
|
61 |
55 |
$0.00 |
| 99072 |
|
70 |
65 |
$0.00 |
| 91300 |
|
66 |
61 |
$0.00 |