| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,953 |
1,883 |
$100K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
866 |
858 |
$36K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
332 |
331 |
$25K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
275 |
271 |
$19K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
229 |
227 |
$17K |
| 99058 |
|
672 |
668 |
$11K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
681 |
339 |
$7K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
654 |
646 |
$7K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
67 |
67 |
$6K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
52 |
52 |
$4K |
| 90651 |
|
63 |
63 |
$208.83 |
| 90670 |
|
262 |
262 |
$0.00 |
| 90715 |
|
26 |
26 |
$0.00 |
| 90734 |
|
41 |
40 |
$0.00 |
| 90700 |
|
20 |
20 |
$0.00 |
| 90633 |
|
178 |
175 |
$0.00 |
| 90710 |
|
118 |
118 |
$0.00 |
| 90648 |
|
82 |
82 |
$0.00 |
| 90685 |
|
16 |
16 |
$0.00 |
| 90698 |
|
106 |
106 |
$0.00 |
| 90744 |
|
68 |
68 |
$0.00 |
| 90680 |
|
108 |
108 |
$0.00 |
| 90686 |
|
110 |
110 |
$0.00 |
| 90723 |
|
72 |
72 |
$0.00 |