| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,098 |
1,950 |
$144K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
831 |
749 |
$83K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
186 |
180 |
$19K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,193 |
656 |
$11K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
84 |
80 |
$8K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
148 |
126 |
$6K |
| 90461 |
|
175 |
153 |
$4K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
36 |
36 |
$4K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
29 |
28 |
$3K |
| 90686 |
|
148 |
136 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
154 |
141 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
138 |
67 |
$1K |
| 90698 |
|
54 |
54 |
$1K |
| 99050 |
|
77 |
72 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
104 |
98 |
$977.76 |
| 90670 |
|
39 |
38 |
$861.36 |
| 90633 |
|
15 |
15 |
$325.92 |
| 83655 |
|
12 |
12 |
$142.68 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
14 |
14 |
$124.04 |
| 96127 |
|
12 |
12 |
$51.81 |
| 85018 |
|
12 |
12 |
$27.96 |
| 99000 |
|
155 |
136 |
$3.00 |
| 36416 |
|
14 |
14 |
$0.00 |