| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
571 |
434 |
$92K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
185 |
136 |
$23K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
32 |
14 |
$3K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
22 |
14 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
16 |
13 |
$1K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
57 |
57 |
$254.72 |
| 85018 |
|
68 |
68 |
$24.60 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
19 |
19 |
$0.00 |
| 90656 |
|
16 |
16 |
$0.00 |
| 92551 |
|
17 |
17 |
$0.00 |
| G8483 |
Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons) |
42 |
39 |
$0.00 |
| 81002 |
|
14 |
14 |
$0.00 |
| 99173 |
|
29 |
29 |
$0.00 |
| G8482 |
Influenza immunization administered or previously received |
67 |
61 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
15 |
15 |
$0.00 |
| 90461 |
|
16 |
16 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
17 |
16 |
$0.00 |