| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,238 |
1,106 |
$68K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
285 |
257 |
$22K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
152 |
145 |
$11K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
63 |
62 |
$5K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
169 |
164 |
$5K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
47 |
46 |
$4K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
145 |
135 |
$2K |
| 90670 |
|
134 |
131 |
$2K |
| 90698 |
|
102 |
98 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$1K |
| 94760 |
|
562 |
503 |
$982.48 |
| 92551 |
|
80 |
78 |
$791.50 |
| 90686 |
|
56 |
53 |
$600.94 |
| 90734 |
|
15 |
15 |
$494.34 |
| 90651 |
|
12 |
12 |
$474.84 |
| 90461 |
|
328 |
320 |
$449.90 |
| 81002 |
|
166 |
160 |
$416.40 |
| 99173 |
|
164 |
162 |
$401.37 |
| 90633 |
|
25 |
25 |
$277.75 |
| 90680 |
|
24 |
24 |
$264.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
459 |
449 |
$209.58 |
| 90715 |
|
12 |
12 |
$197.69 |
| 90710 |
|
14 |
14 |
$156.75 |
| 96127 |
|
29 |
27 |
$128.12 |
| 96160 |
|
36 |
35 |
$106.99 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
14 |
14 |
$65.40 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
14 |
14 |
$0.00 |