| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,692 |
2,348 |
$133K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
753 |
700 |
$48K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,744 |
1,720 |
$39K |
| 92588 |
|
1,156 |
1,150 |
$30K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
333 |
333 |
$25K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
289 |
289 |
$21K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
101 |
101 |
$8K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,154 |
1,146 |
$8K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
107 |
106 |
$7K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
482 |
299 |
$6K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
574 |
554 |
$5K |
| 90686 |
|
344 |
344 |
$4K |
| 90461 |
|
150 |
150 |
$3K |
| 99401 |
|
84 |
83 |
$631.95 |
| 96127 |
|
187 |
187 |
$611.96 |
| 97802 |
|
43 |
43 |
$341.80 |
| 92587 |
|
18 |
18 |
$304.21 |
| 36416 |
|
27 |
27 |
$39.45 |
| 99072 |
|
321 |
288 |
$0.00 |
| 90633 |
|
14 |
13 |
$0.00 |
| 90670 |
|
15 |
15 |
$0.00 |