| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
681 |
605 |
$19K |
| H1000 |
Prenatal care, at-risk assessment |
242 |
126 |
$10K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
270 |
239 |
$10K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
74 |
69 |
$5K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12 |
12 |
$961.94 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
163 |
156 |
$290.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
64 |
62 |
$160.00 |
| 90686 |
|
17 |
16 |
$30.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
14 |
13 |
$19.86 |
| 86403 |
|
19 |
18 |
$4.46 |
| 90723 |
|
27 |
26 |
$0.00 |
| 90648 |
|
30 |
29 |
$0.00 |
| 90670 |
|
43 |
41 |
$0.00 |