| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,050 |
3,741 |
$111K |
| T1015 |
Clinic visit/encounter, all-inclusive |
5,795 |
5,287 |
$90K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
530 |
509 |
$22K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
227 |
225 |
$12K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
86 |
85 |
$4K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
417 |
412 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
705 |
689 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
29 |
29 |
$2K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
327 |
292 |
$1K |
| 90686 |
|
45 |
44 |
$608.96 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
12 |
12 |
$436.74 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
12 |
12 |
$430.90 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
14 |
13 |
$202.88 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
20 |
18 |
$154.56 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
35 |
35 |
$27.42 |
| 81003 |
|
12 |
12 |
$3.74 |
| 3008F |
|
3,751 |
3,543 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
12 |
12 |
$0.00 |