| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
854 |
822 |
$67K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
39 |
39 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
12 |
12 |
$2K |
| 90686 |
|
230 |
226 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
491 |
480 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$976.71 |
| 99177 |
|
273 |
271 |
$971.73 |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
43 |
40 |
$336.60 |
| 99051 |
|
64 |
63 |
$191.51 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
46 |
39 |
$139.67 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
52 |
51 |
$136.69 |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
74 |
72 |
$67.13 |
| 96127 |
|
25 |
25 |
$0.00 |