| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
10,897 |
9,854 |
$874K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,839 |
3,390 |
$352K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
293 |
287 |
$38K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,266 |
1,214 |
$28K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
179 |
172 |
$19K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
127 |
127 |
$16K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
101 |
101 |
$13K |
| S0281 |
Medical home program, comprehensive care coordination and planning, maintenance of plan |
1,096 |
1,096 |
$5K |
| 90670 |
|
92 |
86 |
$4K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
202 |
188 |
$3K |
| 90686 |
|
280 |
276 |
$2K |
| 90698 |
|
78 |
75 |
$2K |
| 90461 |
|
360 |
351 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
94 |
76 |
$1K |
| 90734 |
|
12 |
12 |
$938.32 |
| 90710 |
|
14 |
14 |
$840.78 |
| 90744 |
|
24 |
24 |
$220.10 |
| 90696 |
|
13 |
13 |
$194.97 |
| S0315 |
Disease management program; initial assessment and initiation of the program |
24 |
24 |
$180.00 |
| 99000 |
|
1,201 |
1,127 |
$95.64 |
| 90715 |
|
14 |
14 |
$84.22 |
| 90685 |
|
12 |
12 |
$73.49 |