| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,799 |
4,921 |
$292K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,354 |
1,313 |
$23K |
| 92587 |
|
667 |
642 |
$15K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
121 |
121 |
$7K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
118 |
118 |
$7K |
| 90686 |
|
376 |
374 |
$4K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
96 |
95 |
$4K |
| 99401 |
|
250 |
249 |
$3K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
84 |
84 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
18 |
16 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
15 |
15 |
$762.52 |
| 92553 |
|
42 |
42 |
$685.84 |
| 92567 |
|
94 |
92 |
$671.34 |
| 90461 |
|
38 |
38 |
$635.00 |
| 90674 |
|
19 |
19 |
$415.68 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
14 |
14 |
$219.02 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
14 |
13 |
$169.72 |
| 90656 |
|
21 |
21 |
$67.05 |
| 36415 |
Collection of venous blood by venipuncture |
12 |
12 |
$21.44 |