| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
204 |
195 |
$5K |
| 86703 |
|
670 |
653 |
$3K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
268 |
250 |
$3K |
| 86592 |
|
868 |
836 |
$3K |
| 87210 |
|
331 |
318 |
$1K |
| 81025 |
|
169 |
160 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
32 |
28 |
$1K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
207 |
82 |
$520.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
115 |
98 |
$360.00 |
| 86803 |
|
108 |
101 |
$335.72 |
| 86780 |
|
13 |
12 |
$96.84 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
14 |
14 |
$87.68 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
12 |
12 |
$52.32 |
| 90686 |
|
50 |
46 |
$0.00 |
| 90619 |
|
14 |
13 |
$0.00 |
| 90651 |
|
16 |
15 |
$0.00 |
| 90715 |
|
15 |
14 |
$0.00 |