| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
755 |
608 |
$33K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
50 |
40 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
36 |
29 |
$3K |
| 96160 |
|
295 |
219 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
32 |
27 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
24 |
12 |
$2K |
| 90686 |
|
249 |
109 |
$2K |
| 96127 |
|
39 |
32 |
$897.20 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
66 |
44 |
$848.18 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
42 |
17 |
$680.93 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
21 |
14 |
$401.75 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
68 |
48 |
$32.36 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
33 |
27 |
$0.00 |