| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
209 |
187 |
$11K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,329 |
1,254 |
$10K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
647 |
625 |
$7K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
125 |
120 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
272 |
269 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
30 |
30 |
$1K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
37 |
35 |
$991.21 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
14 |
12 |
$379.53 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
14 |
12 |
$126.59 |
| 90461 |
|
140 |
136 |
$63.86 |
| 99173 |
|
312 |
304 |
$52.82 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
40 |
40 |
$26.85 |
| 92551 |
|
30 |
26 |
$10.13 |
| 90670 |
|
188 |
178 |
$0.00 |
| S9999 |
Sales tax |
611 |
558 |
$0.00 |
| 90687 |
|
20 |
20 |
$0.00 |
| 90680 |
|
87 |
84 |
$0.00 |
| 90698 |
|
52 |
52 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
27 |
27 |
$0.00 |
| 90688 |
|
37 |
34 |
$0.00 |