| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,416 |
2,213 |
$133K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
249 |
233 |
$18K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
141 |
136 |
$11K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
68 |
63 |
$5K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
181 |
145 |
$4K |
| 92551 |
|
316 |
309 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
204 |
199 |
$3K |
| 90670 |
|
162 |
156 |
$3K |
| 90698 |
|
108 |
105 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
13 |
12 |
$1K |
| 81002 |
|
235 |
228 |
$560.87 |
| 99173 |
|
217 |
210 |
$525.11 |
| 90461 |
|
419 |
403 |
$397.30 |
| 90686 |
|
33 |
33 |
$372.54 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
717 |
693 |
$334.05 |
| 99177 |
|
46 |
46 |
$174.58 |
| 90633 |
|
15 |
14 |
$156.75 |
| 90680 |
|
14 |
14 |
$155.65 |
| 90744 |
|
13 |
13 |
$144.10 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
13 |
13 |
$3.40 |
| 97802 |
|
12 |
12 |
$0.00 |
| 99000 |
|
12 |
12 |
$0.00 |
| 90473 |
|
14 |
14 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
13 |
13 |
$0.00 |