| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99215 |
Prolong outpt/office vis |
2,542 |
2,200 |
$201K |
| 69200 |
|
2,673 |
2,137 |
$198K |
| 99402 |
|
2,446 |
2,048 |
$80K |
| 96112 |
|
1,452 |
1,332 |
$61K |
| 92567 |
|
2,023 |
1,807 |
$26K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
278 |
244 |
$17K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
459 |
437 |
$12K |
| 94667 |
|
2,374 |
2,060 |
$11K |
| 94664 |
|
810 |
749 |
$10K |
| 99173 |
|
1,004 |
944 |
$6K |
| 94010 |
|
175 |
170 |
$4K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
43 |
43 |
$3K |
| 96111 |
|
32 |
31 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
192 |
88 |
$1K |
| 65205 |
|
161 |
138 |
$1K |
| 94760 |
|
1,341 |
1,208 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
13 |
13 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
14 |
13 |
$1K |
| 86328 |
|
12 |
12 |
$338.65 |
| 90656 |
|
13 |
13 |
$138.46 |
| 87430 |
|
28 |
27 |
$118.90 |
| 90686 |
|
13 |
13 |
$20.53 |
| 99058 |
|
49 |
47 |
$0.00 |
| 99000 |
|
49 |
41 |
$0.00 |