| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
7,833 |
7,781 |
$229K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,835 |
4,692 |
$130K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,519 |
2,487 |
$66K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,627 |
1,624 |
$38K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
795 |
786 |
$36K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,450 |
1,449 |
$34K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,104 |
1,104 |
$30K |
| 90677 |
|
249 |
249 |
$21K |
| 99460 |
|
118 |
118 |
$8K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
323 |
322 |
$8K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,441 |
732 |
$6K |
| 99462 |
|
104 |
76 |
$4K |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
2,889 |
2,888 |
$3K |
| 86580 |
|
1,225 |
1,223 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,330 |
1,313 |
$3K |
| G0444 |
Annual depression screening, 5 to 15 minutes |
149 |
149 |
$3K |
| 99441 |
|
88 |
80 |
$2K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
105 |
105 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
15 |
15 |
$206.78 |
| 97802 |
|
4,171 |
4,148 |
$201.59 |
| 90670 |
|
912 |
911 |
$185.00 |
| 90461 |
|
20 |
20 |
$168.72 |
| 90686 |
|
1,104 |
1,091 |
$130.39 |
| 90698 |
|
466 |
465 |
$126.17 |
| 90633 |
|
160 |
160 |
$45.13 |
| 90656 |
|
98 |
98 |
$21.18 |
| 90707 |
|
41 |
41 |
$0.00 |
| 90700 |
|
55 |
55 |
$0.00 |
| 90734 |
|
30 |
30 |
$0.00 |
| 90648 |
|
15 |
15 |
$0.00 |
| 90680 |
|
515 |
514 |
$0.00 |
| 99000 |
|
872 |
865 |
$0.00 |
| 90744 |
|
251 |
249 |
$0.00 |
| 90716 |
|
65 |
65 |
$0.00 |
| 90619 |
|
13 |
13 |
$0.00 |