| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,714 |
2,676 |
$214K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
895 |
807 |
$75K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,112 |
1,105 |
$62K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
194 |
173 |
$16K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
160 |
160 |
$14K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
347 |
323 |
$9K |
| 90474 |
|
358 |
358 |
$6K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
69 |
69 |
$6K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
261 |
250 |
$4K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
31 |
30 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
16 |
16 |
$1K |
| 99460 |
|
16 |
16 |
$1K |
| 90686 |
|
366 |
365 |
$209.39 |
| 87807 |
|
12 |
12 |
$142.08 |
| 90756 |
|
18 |
18 |
$105.08 |
| 90670 |
|
528 |
528 |
$0.00 |
| 90633 |
|
50 |
50 |
$0.00 |
| 90680 |
|
335 |
335 |
$0.00 |
| 90698 |
|
338 |
338 |
$0.00 |
| 90744 |
|
157 |
157 |
$0.00 |