| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,733 |
2,841 |
$199K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,847 |
1,171 |
$80K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,531 |
1,025 |
$77K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
4,976 |
3,226 |
$69K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
886 |
578 |
$47K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
4,340 |
2,728 |
$36K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,380 |
822 |
$35K |
| 92587 |
|
2,049 |
1,339 |
$29K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
499 |
318 |
$29K |
| 99173 |
|
1,928 |
1,271 |
$7K |
| 99381 |
|
92 |
56 |
$4K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
760 |
452 |
$4K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
516 |
251 |
$3K |
| 90461 |
|
3,697 |
1,404 |
$457.29 |
| 87807 |
|
79 |
48 |
$321.86 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
76 |
37 |
$308.25 |
| 90651 |
|
89 |
69 |
$289.22 |
| 90686 |
|
585 |
544 |
$154.73 |
| 94760 |
|
284 |
152 |
$107.07 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
50 |
25 |
$82.00 |
| 81002 |
|
31 |
17 |
$26.58 |
| 90688 |
|
30 |
28 |
$19.24 |
| 90633 |
|
162 |
136 |
$0.00 |
| 90670 |
|
536 |
413 |
$0.00 |
| 90473 |
|
46 |
27 |
$0.00 |
| 90734 |
|
45 |
35 |
$0.00 |
| 90707 |
|
26 |
18 |
$0.00 |
| 90715 |
|
13 |
13 |
$0.00 |
| 90710 |
|
19 |
13 |
$0.00 |
| 90680 |
|
251 |
201 |
$0.00 |
| 90698 |
|
478 |
376 |
$0.00 |
| 90744 |
|
152 |
127 |
$0.00 |
| 90716 |
|
56 |
40 |
$0.00 |
| 90696 |
|
18 |
13 |
$0.00 |
| 90656 |
|
109 |
74 |
$0.00 |