| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,636 |
2,294 |
$97K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
568 |
493 |
$27K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
210 |
203 |
$20K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
891 |
415 |
$12K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
729 |
678 |
$10K |
| 86318 |
|
577 |
514 |
$10K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
685 |
338 |
$7K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
30 |
30 |
$3K |
| 99215 |
Prolong outpt/office vis |
16 |
12 |
$839.22 |
| 81002 |
|
308 |
285 |
$831.43 |
| 90756 |
|
71 |
67 |
$656.48 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
13 |
13 |
$383.77 |
| 90685 |
|
28 |
26 |
$0.00 |
| 90461 |
|
17 |
12 |
$0.00 |
| 90686 |
|
15 |
14 |
$0.00 |