| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,641 |
5,311 |
$192K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
673 |
532 |
$22K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
260 |
245 |
$16K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
318 |
270 |
$12K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,192 |
521 |
$11K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
962 |
854 |
$8K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
126 |
123 |
$6K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
108 |
89 |
$5K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
321 |
234 |
$4K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
220 |
196 |
$3K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
33 |
26 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
42 |
42 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
77 |
72 |
$1K |
| 92552 |
|
111 |
110 |
$1K |
| 90674 |
|
60 |
47 |
$497.93 |
| 96127 |
|
216 |
215 |
$404.81 |
| 3008F |
|
123 |
94 |
$340.00 |
| 87807 |
|
20 |
19 |
$186.10 |
| 36415 |
Collection of venous blood by venipuncture |
174 |
147 |
$115.12 |
| 99173 |
|
108 |
107 |
$113.55 |
| 96161 |
|
22 |
15 |
$106.01 |
| 99177 |
|
28 |
28 |
$52.02 |
| 90686 |
|
98 |
91 |
$44.50 |
| 96160 |
|
48 |
48 |
$44.10 |
| 99406 |
|
27 |
12 |
$42.45 |
| 81003 |
|
30 |
28 |
$35.64 |
| 85018 |
|
13 |
12 |
$35.45 |
| 99441 |
|
15 |
12 |
$25.14 |
| 3074F |
|
18 |
16 |
$10.00 |
| 90670 |
|
64 |
42 |
$0.00 |
| 90648 |
|
15 |
13 |
$0.00 |
| 90633 |
|
13 |
13 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
12 |
12 |
$0.00 |
| 90651 |
|
13 |
13 |
$0.00 |
| 90680 |
|
19 |
13 |
$0.00 |