| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,988 |
2,630 |
$268K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,508 |
1,496 |
$38K |
| 92552 |
|
1,047 |
1,047 |
$28K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
129 |
129 |
$14K |
| 99401 |
|
1,472 |
1,461 |
$12K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
97 |
97 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
15 |
15 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12 |
12 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
68 |
34 |
$731.68 |
| 87110 |
|
42 |
42 |
$535.08 |
| 99441 |
|
14 |
14 |
$394.94 |
| 90686 |
|
880 |
879 |
$300.64 |
| 83655 |
|
37 |
37 |
$200.42 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
476 |
468 |
$144.05 |
| 36415 |
Collection of venous blood by venipuncture |
1,232 |
1,231 |
$123.55 |
| 99173 |
|
1,012 |
1,012 |
$59.20 |
| 99000 |
|
1,413 |
1,398 |
$0.00 |
| 90685 |
|
26 |
26 |
$0.00 |
| 90461 |
|
12 |
12 |
$0.00 |