| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
11,266 |
10,201 |
$496K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
4,386 |
4,065 |
$171K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,829 |
1,617 |
$104K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,005 |
960 |
$66K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
590 |
553 |
$41K |
| 90461 |
|
1,787 |
1,626 |
$20K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
72 |
70 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
28 |
27 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
164 |
158 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
188 |
129 |
$1K |
| 99174 |
|
283 |
260 |
$1K |
| 99381 |
|
12 |
12 |
$987.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
55 |
33 |
$450.28 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
13 |
12 |
$275.00 |
| 87807 |
|
12 |
12 |
$42.79 |
| 85018 |
|
28 |
26 |
$29.58 |
| 99173 |
|
13 |
13 |
$28.17 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
15 |
13 |
$8.54 |
| 90686 |
|
447 |
403 |
$1.28 |
| 90670 |
|
889 |
777 |
$0.04 |
| 90680 |
|
328 |
286 |
$0.00 |
| 90688 |
|
198 |
182 |
$0.00 |
| 90716 |
|
68 |
55 |
$0.00 |
| 90744 |
|
165 |
144 |
$0.00 |
| 90713 |
|
652 |
585 |
$0.00 |
| 90700 |
|
1,097 |
977 |
$0.00 |
| 90648 |
|
693 |
612 |
$0.00 |
| 90685 |
|
78 |
64 |
$0.00 |
| 90707 |
|
62 |
50 |
$0.00 |
| 90633 |
|
103 |
83 |
$0.00 |