| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,116 |
2,382 |
$175K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,044 |
1,721 |
$172K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
829 |
693 |
$62K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
615 |
552 |
$54K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,833 |
1,615 |
$46K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
351 |
339 |
$32K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
250 |
239 |
$25K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
609 |
604 |
$18K |
| 90697 |
|
160 |
144 |
$10K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
488 |
449 |
$5K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
20 |
18 |
$3K |
| 99223 |
Prolong inpt eval add15 m |
12 |
12 |
$2K |
| 90671 |
|
151 |
151 |
$2K |
| 90461 |
|
49 |
49 |
$1K |
| 99233 |
Prolong inpt eval add15 m |
16 |
12 |
$588.60 |
| 90619 |
|
15 |
15 |
$521.24 |
| 97803 |
|
48 |
27 |
$27.22 |
| 99173 |
|
646 |
519 |
$0.00 |
| 90707 |
|
21 |
16 |
$0.00 |
| 90670 |
|
147 |
118 |
$0.00 |
| 90648 |
|
55 |
45 |
$0.00 |
| 90658 |
|
57 |
57 |
$0.00 |
| 90700 |
|
13 |
12 |
$0.00 |
| 92551 |
|
661 |
535 |
$0.00 |
| 90680 |
|
98 |
80 |
$0.00 |
| 90651 |
|
29 |
29 |
$0.00 |
| 90657 |
|
13 |
12 |
$0.00 |
| 90716 |
|
25 |
25 |
$0.00 |
| 90723 |
|
32 |
25 |
$0.00 |