| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,714 |
1,397 |
$68K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
439 |
346 |
$25K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
397 |
298 |
$13K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
21 |
13 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
229 |
169 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
49 |
47 |
$758.48 |
| 96127 |
|
92 |
58 |
$318.24 |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
24 |
24 |
$302.37 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
46 |
18 |
$255.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
25 |
25 |
$166.98 |
| 90686 |
|
61 |
56 |
$53.73 |
| 90756 |
|
12 |
12 |
$0.04 |
| 90688 |
|
31 |
31 |
$0.00 |