| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,925 |
1,734 |
$97K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
508 |
467 |
$10K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
65 |
58 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
54 |
52 |
$3K |
| 90461 |
|
61 |
52 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
14 |
14 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
63 |
51 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
115 |
97 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
66 |
58 |
$896.00 |
| 96127 |
|
61 |
57 |
$171.41 |
| 85018 |
|
12 |
12 |
$25.92 |