| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,050 |
884 |
$37K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
486 |
430 |
$30K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
273 |
238 |
$15K |
| 90670 |
|
77 |
66 |
$8K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
154 |
142 |
$6K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
13 |
13 |
$994.88 |
| 99188 |
|
12 |
12 |
$53.98 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
224 |
188 |
$30.00 |
| 90648 |
|
111 |
101 |
$20.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
77 |
63 |
$0.00 |
| 90723 |
|
14 |
14 |
$0.00 |
| 92587 |
|
19 |
19 |
$0.00 |