| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
484 |
457 |
$25K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
12 |
12 |
$958.96 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
14 |
14 |
$921.62 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12 |
12 |
$884.88 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
12 |
12 |
$873.48 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
114 |
114 |
$781.69 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
49 |
49 |
$691.18 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
12 |
12 |
$391.20 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
14 |
14 |
$367.48 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
16 |
16 |
$218.34 |
| 99051 |
|
25 |
25 |
$99.40 |
| 96127 |
|
12 |
12 |
$39.15 |
| 2000F |
|
73 |
68 |
$0.71 |
| 3078F |
|
85 |
80 |
$0.00 |
| 90670 |
|
13 |
13 |
$0.00 |
| 90686 |
|
48 |
48 |
$0.00 |
| 3074F |
|
84 |
79 |
$0.00 |
| 90698 |
|
13 |
13 |
$0.00 |