| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,776 |
2,053 |
$216K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
289 |
242 |
$15K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
576 |
554 |
$5K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
26 |
26 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
12 |
12 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
61 |
30 |
$871.24 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
32 |
32 |
$746.14 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
179 |
165 |
$711.36 |
| 92568 |
|
27 |
27 |
$346.41 |
| 81000 |
|
51 |
49 |
$202.79 |
| 92567 |
|
14 |
14 |
$90.52 |
| 97802 |
|
156 |
135 |
$27.24 |
| 97803 |
|
51 |
51 |
$22.50 |
| 99173 |
|
152 |
152 |
$1.74 |
| 99072 |
|
144 |
101 |
$0.00 |
| 99000 |
|
211 |
183 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
123 |
120 |
$0.00 |
| 90686 |
|
19 |
19 |
$0.00 |
| 90887 |
|
44 |
39 |
$0.00 |