| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,206 |
1,870 |
$97K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
605 |
569 |
$38K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
184 |
184 |
$9K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
573 |
556 |
$7K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
602 |
598 |
$7K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
301 |
295 |
$5K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
86 |
83 |
$4K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
352 |
345 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
40 |
40 |
$2K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
116 |
113 |
$1K |
| 90686 |
|
125 |
125 |
$980.30 |
| 92552 |
|
64 |
64 |
$850.30 |
| 99401 |
|
39 |
39 |
$758.46 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$700.61 |
| 3008F |
|
553 |
553 |
$640.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
67 |
33 |
$399.84 |
| 99173 |
|
331 |
331 |
$324.20 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
61 |
60 |
$0.00 |