| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,762 |
1,440 |
$44K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
464 |
386 |
$15K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
164 |
142 |
$7K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
76 |
63 |
$5K |
| 92587 |
|
568 |
448 |
$3K |
| 99215 |
Prolong outpt/office vis |
18 |
16 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
253 |
198 |
$827.36 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
263 |
179 |
$575.75 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
85 |
59 |
$560.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
13 |
12 |
$203.60 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
38 |
33 |
$69.72 |
| 92558 |
|
14 |
12 |
$42.04 |
| 99177 |
|
549 |
439 |
$11.42 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
25 |
12 |
$9.97 |
| 85018 |
|
29 |
25 |
$4.41 |
| 96160 |
|
61 |
52 |
$0.00 |
| 83655 |
|
13 |
12 |
$0.00 |
| 90677 |
|
14 |
13 |
$0.00 |
| 36416 |
|
15 |
13 |
$0.00 |
| 90698 |
|
13 |
12 |
$0.00 |
| 99000 |
|
25 |
19 |
$0.00 |
| 90686 |
|
13 |
13 |
$0.00 |
| 92551 |
|
12 |
12 |
$0.00 |