| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,895 |
3,718 |
$29K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,206 |
1,204 |
$10K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,312 |
1,312 |
$5K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
926 |
925 |
$5K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,639 |
1,634 |
$5K |
| 92551 |
|
3,326 |
3,321 |
$4K |
| 99173 |
|
2,471 |
2,467 |
$2K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
157 |
157 |
$1K |
| 90473 |
|
413 |
413 |
$929.35 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
132 |
132 |
$573.92 |
| 90686 |
|
531 |
531 |
$124.45 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
38 |
38 |
$101.32 |
| 86580 |
|
25 |
25 |
$69.18 |
| 90672 |
|
185 |
185 |
$53.76 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
14 |
14 |
$40.00 |
| 87400 |
|
13 |
13 |
$0.00 |
| 3008F |
|
2,360 |
2,351 |
$0.00 |
| 90651 |
|
13 |
13 |
$0.00 |