| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
535 |
410 |
$26K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
247 |
195 |
$17K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
145 |
135 |
$13K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
440 |
284 |
$9K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
69 |
61 |
$7K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
33 |
31 |
$3K |
| 90621 |
|
13 |
12 |
$2K |
| 90461 |
|
66 |
54 |
$1K |
| 90688 |
|
57 |
50 |
$869.34 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
36 |
34 |
$575.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
68 |
57 |
$413.70 |
| 90686 |
|
16 |
16 |
$376.80 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
68 |
61 |
$350.00 |
| 36416 |
|
16 |
13 |
$1.25 |
| 99000 |
|
73 |
62 |
$0.00 |