| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,118 |
906 |
$50K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
241 |
214 |
$17K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
435 |
412 |
$13K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
173 |
171 |
$13K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
171 |
167 |
$11K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
70 |
67 |
$5K |
| 92552 |
|
193 |
183 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$991.19 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
14 |
12 |
$784.25 |
| 94760 |
|
1,365 |
1,118 |
$200.15 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
17 |
17 |
$198.85 |
| 99173 |
|
190 |
175 |
$179.35 |
| 90670 |
|
44 |
44 |
$0.00 |
| 96127 |
|
16 |
12 |
$0.00 |
| 90686 |
|
38 |
33 |
$0.00 |
| 90723 |
|
24 |
24 |
$0.00 |
| 90680 |
|
12 |
12 |
$0.00 |