| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,527 |
2,259 |
$143K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,797 |
1,569 |
$107K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,145 |
1,130 |
$77K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,957 |
1,906 |
$35K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,189 |
2,134 |
$19K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
221 |
220 |
$15K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
715 |
700 |
$9K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
174 |
136 |
$9K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
88 |
87 |
$6K |
| 99460 |
|
123 |
114 |
$6K |
| 90473 |
|
486 |
470 |
$5K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
117 |
112 |
$3K |
| 99051 |
|
97 |
96 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
12 |
12 |
$846.87 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
43 |
22 |
$458.00 |
| 99462 |
|
17 |
15 |
$409.36 |
| 90461 |
|
15 |
12 |
$129.34 |
| 99173 |
|
39 |
38 |
$62.79 |
| 90686 |
|
133 |
131 |
$23.00 |
| 90685 |
|
16 |
14 |
$7.50 |
| 90670 |
|
23 |
12 |
$1.10 |