| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,912 |
1,506 |
$75K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
464 |
362 |
$20K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
234 |
170 |
$13K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
543 |
394 |
$10K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
638 |
258 |
$7K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
631 |
531 |
$7K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
237 |
171 |
$6K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
76 |
60 |
$5K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
46 |
33 |
$3K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
248 |
213 |
$2K |
| 92551 |
|
240 |
175 |
$2K |
| 96161 |
|
154 |
106 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
17 |
12 |
$1K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
61 |
52 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
15 |
12 |
$974.20 |
| 87807 |
|
78 |
57 |
$676.07 |
| 81003 |
|
320 |
244 |
$600.26 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
53 |
44 |
$557.83 |
| 95115 |
|
44 |
25 |
$308.33 |
| 96127 |
|
71 |
36 |
$306.81 |
| 85018 |
|
58 |
39 |
$97.48 |
| 90686 |
|
122 |
97 |
$44.50 |
| 99173 |
|
160 |
103 |
$1.50 |
| 90723 |
|
52 |
40 |
$0.00 |
| 90647 |
|
35 |
28 |
$0.00 |
| 90670 |
|
132 |
97 |
$0.00 |
| 90710 |
|
20 |
15 |
$0.00 |