| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,871 |
3,418 |
$87K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
685 |
685 |
$40K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
606 |
602 |
$34K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
349 |
333 |
$21K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
455 |
438 |
$17K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
255 |
235 |
$16K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
996 |
935 |
$5K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
219 |
210 |
$2K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
24 |
13 |
$2K |
| 90686 |
|
367 |
349 |
$1K |
| 96127 |
|
391 |
358 |
$1K |
| 0012A |
|
22 |
22 |
$840.00 |
| 0011A |
|
22 |
22 |
$840.00 |
| 0071A |
|
28 |
28 |
$643.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
86 |
82 |
$447.78 |
| 0072A |
|
24 |
24 |
$440.00 |
| 99050 |
|
15 |
15 |
$252.33 |
| 92551 |
|
75 |
66 |
$160.00 |
| 99173 |
|
76 |
67 |
$126.00 |
| 90656 |
|
51 |
51 |
$60.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
17 |
16 |
$48.00 |
| 96160 |
|
13 |
13 |
$27.30 |
| 90677 |
|
25 |
25 |
$0.00 |
| 91307 |
|
51 |
29 |
$0.00 |
| 91301 |
|
39 |
37 |
$0.00 |