| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99215 |
Prolong outpt/office vis |
20,901 |
9,215 |
$2.14M |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
3,728 |
3,654 |
$140K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
2,781 |
2,723 |
$107K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
3,112 |
3,011 |
$101K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
4,048 |
3,993 |
$52K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,361 |
3,231 |
$51K |
| 99205 |
Prolong outpt/office vis |
276 |
276 |
$38K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
891 |
863 |
$30K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
2,173 |
1,944 |
$16K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
952 |
927 |
$11K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,889 |
1,832 |
$8K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
73 |
73 |
$5K |
| 99383 |
|
43 |
43 |
$2K |
| 90461 |
|
366 |
364 |
$2K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
636 |
631 |
$1K |
| 99384 |
|
12 |
12 |
$830.52 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
294 |
291 |
$526.80 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
977 |
963 |
$375.00 |
| 97803 |
|
10,237 |
9,806 |
$73.48 |
| 90686 |
|
458 |
456 |
$71.47 |
| 90656 |
|
228 |
228 |
$39.03 |
| 90671 |
|
61 |
61 |
$15.04 |
| 90715 |
|
137 |
137 |
$6.01 |
| 90734 |
|
131 |
131 |
$6.01 |
| 90707 |
|
38 |
38 |
$2.00 |
| 90696 |
|
15 |
15 |
$0.01 |
| 90710 |
|
34 |
34 |
$0.01 |
| 97802 |
|
3,264 |
3,153 |
$0.00 |
| 87430 |
|
134 |
134 |
$0.00 |
| 85027 |
|
13 |
13 |
$0.00 |
| 90716 |
|
14 |
14 |
$0.00 |
| 90700 |
|
127 |
127 |
$0.00 |
| 90713 |
|
76 |
76 |
$0.00 |
| 90633 |
|
16 |
16 |
$0.00 |
| 83655 |
|
42 |
42 |
$0.00 |
| 90670 |
|
58 |
55 |
$0.00 |