| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
476 |
460 |
$23K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
30 |
30 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
159 |
159 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12 |
12 |
$971.58 |
| 3008F |
|
91 |
91 |
$900.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
29 |
29 |
$667.00 |
| 96127 |
|
149 |
149 |
$425.03 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
53 |
52 |
$296.98 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
50 |
25 |
$268.00 |
| 90686 |
|
12 |
12 |
$207.60 |
| 87999 |
|
12 |
12 |
$144.00 |
| 99173 |
|
59 |
59 |
$128.62 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
12 |
12 |
$57.00 |