| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,449 |
1,193 |
$58K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
960 |
829 |
$36K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
290 |
248 |
$18K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
307 |
234 |
$17K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
260 |
230 |
$15K |
| 97802 |
|
566 |
469 |
$6K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
63 |
57 |
$4K |
| 92552 |
|
194 |
173 |
$3K |
| 3008F |
|
772 |
651 |
$3K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
398 |
145 |
$3K |
| 96127 |
|
604 |
496 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
283 |
216 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
68 |
68 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
21 |
15 |
$966.32 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
76 |
65 |
$810.98 |
| 96161 |
|
133 |
122 |
$305.94 |
| 99173 |
|
93 |
85 |
$158.56 |
| 96160 |
|
72 |
59 |
$143.33 |
| 99177 |
|
42 |
31 |
$139.06 |
| 92587 |
|
12 |
12 |
$100.44 |
| 90686 |
|
318 |
301 |
$4.59 |
| 90680 |
|
14 |
14 |
$0.00 |
| 90647 |
|
40 |
38 |
$0.00 |
| 99000 |
|
80 |
76 |
$0.00 |
| 90723 |
|
16 |
16 |
$0.00 |
| 90670 |
|
131 |
122 |
$0.00 |
| 90685 |
|
30 |
30 |
$0.00 |
| 99072 |
|
48 |
48 |
$0.00 |
| 90633 |
|
12 |
12 |
$0.00 |