| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,130 |
2,700 |
$134K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,602 |
1,513 |
$102K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
3,288 |
1,281 |
$52K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
808 |
749 |
$42K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
700 |
687 |
$40K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
390 |
384 |
$22K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
182 |
179 |
$12K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
356 |
349 |
$4K |
| 99051 |
|
136 |
127 |
$2K |
| 99381 |
|
27 |
27 |
$2K |
| 90670 |
|
560 |
548 |
$1K |
| 90698 |
|
382 |
372 |
$960.00 |
| 90680 |
|
264 |
258 |
$680.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
38 |
37 |
$445.47 |
| 90633 |
|
134 |
132 |
$390.00 |
| 90744 |
|
129 |
129 |
$320.00 |
| 92551 |
|
28 |
28 |
$144.94 |
| 90686 |
|
54 |
48 |
$130.00 |
| 90734 |
|
31 |
31 |
$100.00 |
| 90710 |
|
17 |
17 |
$70.00 |
| 90700 |
|
25 |
25 |
$70.00 |
| 90651 |
|
27 |
25 |
$60.00 |
| 99173 |
|
29 |
29 |
$59.76 |
| 90696 |
|
14 |
14 |
$50.00 |
| 90716 |
|
13 |
13 |
$20.00 |