| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,855 |
4,333 |
$316K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
327 |
301 |
$29K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
111 |
111 |
$11K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
425 |
423 |
$9K |
| 90461 |
|
198 |
198 |
$5K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
26 |
26 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
19 |
17 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
84 |
81 |
$2K |
| 87428 |
|
30 |
29 |
$1K |
| 90686 |
|
67 |
66 |
$520.60 |
| 86710 |
|
23 |
23 |
$330.90 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
22 |
22 |
$297.60 |
| 36415 |
Collection of venous blood by venipuncture |
13 |
12 |
$33.24 |
| 90670 |
|
50 |
50 |
$0.00 |
| 90698 |
|
24 |
24 |
$0.00 |
| 90680 |
|
12 |
12 |
$0.00 |