| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,116 |
1,023 |
$54K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,017 |
690 |
$12K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
295 |
276 |
$10K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
116 |
100 |
$6K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
30 |
30 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
32 |
31 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
100 |
100 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
17 |
16 |
$1K |
| 90461 |
|
33 |
27 |
$541.40 |
| 92551 |
|
46 |
46 |
$452.85 |
| 90686 |
|
41 |
41 |
$435.11 |
| 92565 |
|
72 |
72 |
$407.03 |
| 99177 |
|
58 |
58 |
$371.40 |
| 92587 |
|
14 |
14 |
$272.48 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
14 |
13 |
$142.96 |
| 97802 |
|
162 |
162 |
$119.60 |
| 86580 |
|
28 |
28 |
$118.90 |
| 96127 |
|
40 |
40 |
$50.72 |