| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,345 |
2,113 |
$134K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
777 |
721 |
$64K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
243 |
243 |
$21K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
240 |
239 |
$18K |
| 90686 |
|
939 |
927 |
$11K |
| 92551 |
|
1,107 |
1,072 |
$11K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
89 |
82 |
$7K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
270 |
128 |
$3K |
| 99173 |
|
1,106 |
1,074 |
$3K |
| 90658 |
|
195 |
183 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
12 |
12 |
$2K |
| 90651 |
|
27 |
27 |
$1K |
| 0071A |
|
30 |
30 |
$1K |
| 0072A |
|
30 |
30 |
$1K |
| 0002A |
|
28 |
28 |
$1K |
| 0001A |
|
25 |
24 |
$960.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
195 |
189 |
$780.60 |
| 90734 |
|
13 |
12 |
$379.54 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
26 |
25 |
$347.19 |
| 90657 |
|
15 |
14 |
$165.79 |
| 90685 |
|
12 |
12 |
$137.93 |
| 91300 |
|
54 |
39 |
$0.00 |
| 91307 |
|
70 |
52 |
$0.00 |