| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
613 |
564 |
$24K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,194 |
470 |
$18K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
276 |
238 |
$13K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
176 |
166 |
$9K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
98 |
94 |
$6K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
73 |
68 |
$4K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
15 |
14 |
$178.43 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
15 |
15 |
$117.35 |
| 96127 |
|
33 |
29 |
$108.59 |
| 36416 |
|
44 |
40 |
$77.88 |
| 90686 |
|
117 |
109 |
$56.08 |
| 90648 |
|
213 |
191 |
$25.11 |
| 90670 |
|
216 |
194 |
$25.03 |
| 90723 |
|
141 |
123 |
$20.08 |
| 90685 |
|
77 |
60 |
$7.05 |
| 90710 |
|
35 |
31 |
$1.00 |
| 90633 |
|
35 |
32 |
$1.00 |