| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
407 |
388 |
$22K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
40 |
40 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
30 |
29 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
27 |
25 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
14 |
14 |
$1K |
| 90686 |
|
80 |
77 |
$915.13 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
42 |
19 |
$529.38 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
105 |
103 |
$231.90 |
| 90648 |
|
14 |
14 |
$143.00 |
| 90670 |
|
14 |
14 |
$143.00 |
| 99173 |
|
48 |
47 |
$115.11 |
| 99051 |
|
99 |
95 |
$81.09 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
42 |
41 |
$60.77 |
| 90461 |
|
62 |
62 |
$20.60 |