| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
275 |
112 |
$15K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,234 |
843 |
$15K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
79 |
74 |
$5K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
33 |
27 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
86 |
52 |
$938.59 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
18 |
13 |
$719.90 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
55 |
52 |
$575.90 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
165 |
125 |
$350.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
539 |
290 |
$285.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
182 |
115 |
$79.40 |
| 90685 |
|
40 |
40 |
$10.00 |
| 85018 |
|
13 |
13 |
$3.90 |
| 90686 |
|
130 |
62 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
85 |
71 |
$0.00 |
| 90670 |
|
54 |
41 |
$0.00 |