| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,617 |
1,406 |
$72K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,945 |
901 |
$40K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
271 |
235 |
$18K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
241 |
216 |
$16K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
245 |
192 |
$14K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
189 |
160 |
$5K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
399 |
315 |
$4K |
| 92551 |
|
432 |
358 |
$3K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
318 |
147 |
$3K |
| 3008F |
|
627 |
532 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
37 |
37 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
232 |
208 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
13 |
13 |
$1K |
| 96127 |
|
257 |
216 |
$870.36 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
56 |
56 |
$790.54 |
| 96161 |
|
56 |
38 |
$590.01 |
| 90686 |
|
408 |
372 |
$544.11 |
| 90670 |
|
87 |
65 |
$501.86 |
| 87070 |
|
132 |
117 |
$489.56 |
| 90698 |
|
87 |
65 |
$254.00 |
| 96160 |
|
33 |
33 |
$199.57 |
| 99173 |
|
46 |
39 |
$172.56 |
| 99051 |
|
27 |
27 |
$88.48 |
| 36416 |
|
43 |
37 |
$36.85 |
| 3210F |
|
232 |
208 |
$0.00 |
| 99072 |
|
152 |
133 |
$0.00 |
| 90685 |
|
35 |
35 |
$0.00 |
| 90633 |
|
12 |
12 |
$0.00 |
| 99000 |
|
37 |
35 |
$0.00 |