| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
954 |
861 |
$35K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
320 |
293 |
$29K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
273 |
228 |
$24K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
396 |
369 |
$23K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
216 |
200 |
$17K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
102 |
91 |
$8K |
| 90686 |
|
39 |
39 |
$257.97 |
| 90651 |
|
40 |
40 |
$190.00 |
| 90670 |
|
165 |
152 |
$80.00 |
| 90688 |
|
21 |
21 |
$50.00 |
| 90723 |
|
93 |
82 |
$40.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
366 |
343 |
$40.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
634 |
601 |
$30.00 |
| 90734 |
|
13 |
13 |
$20.00 |
| 90633 |
|
30 |
25 |
$20.00 |
| 90647 |
|
61 |
60 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
39 |
35 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
242 |
237 |
$0.00 |