| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,383 |
1,255 |
$134K |
| 87428 |
|
309 |
304 |
$22K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
194 |
192 |
$22K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
803 |
405 |
$21K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
140 |
140 |
$16K |
| 90461 |
|
551 |
241 |
$15K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
65 |
65 |
$8K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
336 |
332 |
$6K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
73 |
72 |
$4K |
| 99080 |
|
158 |
157 |
$3K |
| 99460 |
|
30 |
30 |
$3K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
34 |
33 |
$3K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
72 |
59 |
$1K |
| 96160 |
|
188 |
160 |
$874.16 |
| 87807 |
|
40 |
40 |
$652.85 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
20 |
20 |
$462.84 |
| 96127 |
|
15 |
14 |
$340.86 |
| 90677 |
|
60 |
60 |
$0.00 |
| 90680 |
|
44 |
44 |
$0.00 |
| 90647 |
|
30 |
30 |
$0.00 |
| 90686 |
|
63 |
63 |
$0.00 |
| 90671 |
|
17 |
15 |
$0.00 |