| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,169 |
1,130 |
$78K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
595 |
588 |
$31K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
257 |
251 |
$10K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
85 |
85 |
$9K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
54 |
54 |
$5K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
48 |
48 |
$4K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
13 |
13 |
$237.12 |
| 96161 |
|
12 |
12 |
$57.48 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
13 |
13 |
$19.25 |
| 96160 |
|
24 |
24 |
$19.16 |
| 99173 |
|
42 |
42 |
$0.00 |
| 90670 |
|
13 |
13 |
$0.00 |
| 3008F |
|
1,230 |
1,184 |
$0.00 |
| 92551 |
|
14 |
14 |
$0.00 |