| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,467 |
3,939 |
$215K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,489 |
1,346 |
$120K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
392 |
379 |
$30K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
295 |
288 |
$26K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,803 |
822 |
$25K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,524 |
1,449 |
$23K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,439 |
1,336 |
$19K |
| 90461 |
|
912 |
782 |
$19K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
25 |
25 |
$2K |
| 81003 |
|
319 |
296 |
$789.19 |
| 86308 |
|
14 |
14 |
$56.97 |
| 90670 |
|
25 |
25 |
$0.00 |
| 90686 |
|
304 |
298 |
$0.00 |