| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,135 |
2,909 |
$123K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,249 |
1,175 |
$71K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,791 |
1,529 |
$56K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
352 |
338 |
$20K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
364 |
346 |
$18K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
68 |
65 |
$4K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
33 |
33 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
109 |
100 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
13 |
13 |
$288.46 |
| 90671 |
|
31 |
25 |
$246.20 |
| 90686 |
|
344 |
329 |
$219.64 |
| 90670 |
|
118 |
117 |
$0.00 |
| 90680 |
|
53 |
52 |
$0.00 |
| 90698 |
|
40 |
40 |
$0.00 |
| 94760 |
|
61 |
55 |
$0.00 |
| 90697 |
|
14 |
13 |
$0.00 |