| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,288 |
1,154 |
$71K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
521 |
308 |
$11K |
| 90461 |
|
89 |
64 |
$5K |
| 99173 |
|
117 |
117 |
$3K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
29 |
29 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
25 |
25 |
$2K |
| 92552 |
|
136 |
136 |
$2K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
20 |
20 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
16 |
16 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
54 |
27 |
$840.24 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
26 |
26 |
$540.80 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
21 |
12 |
$436.80 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
20 |
16 |
$241.00 |
| 96160 |
|
38 |
38 |
$94.38 |
| 90686 |
|
28 |
28 |
$76.36 |
| 94760 |
|
27 |
25 |
$24.72 |
| 90670 |
|
14 |
14 |
$0.14 |