| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,145 |
3,544 |
$244K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
317 |
312 |
$24K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
253 |
245 |
$19K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
222 |
221 |
$19K |
| 90686 |
|
436 |
430 |
$5K |
| 90672 |
|
237 |
232 |
$4K |
| 90688 |
|
349 |
339 |
$4K |
| 0001A |
|
57 |
57 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
177 |
169 |
$2K |
| 0002A |
|
35 |
35 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
870 |
826 |
$1K |
| 90658 |
|
86 |
84 |
$992.92 |
| 0072A |
|
23 |
23 |
$920.00 |
| 0071A |
|
19 |
19 |
$760.00 |
| 90685 |
|
35 |
32 |
$369.79 |
| 90655 |
|
16 |
16 |
$176.76 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
287 |
128 |
$136.92 |
| 90700 |
|
12 |
12 |
$121.00 |
| 91300 |
|
106 |
100 |
$0.46 |
| 91307 |
|
75 |
70 |
$0.00 |