| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,234 |
2,016 |
$103K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
3,091 |
3,049 |
$70K |
| 90671 |
|
208 |
208 |
$45K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
787 |
722 |
$38K |
| 90461 |
|
571 |
570 |
$28K |
| 90697 |
|
90 |
90 |
$12K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
199 |
199 |
$10K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
194 |
194 |
$10K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
193 |
192 |
$9K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
305 |
171 |
$4K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
42 |
42 |
$2K |
| 36415 |
Collection of venous blood by venipuncture |
956 |
943 |
$2K |
| 90651 |
|
128 |
128 |
$2K |
| 90688 |
|
100 |
98 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
188 |
184 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
43 |
41 |
$1K |
| 81003 |
|
459 |
450 |
$911.38 |
| 96127 |
|
262 |
261 |
$735.89 |
| 86580 |
|
76 |
73 |
$416.94 |
| 92587 |
|
17 |
17 |
$400.13 |
| 99173 |
|
218 |
216 |
$371.19 |
| 90686 |
|
444 |
440 |
$340.90 |
| 90715 |
|
36 |
36 |
$229.80 |
| 90656 |
|
214 |
214 |
$173.78 |
| 96380 |
|
12 |
12 |
$170.00 |
| 90698 |
|
34 |
34 |
$123.00 |
| 90633 |
|
231 |
231 |
$41.95 |
| 99072 |
|
614 |
587 |
$10.00 |
| 90619 |
|
123 |
123 |
$0.14 |
| 3008F |
|
495 |
487 |
$0.00 |
| 99429 |
|
152 |
124 |
$0.00 |
| 90696 |
|
16 |
16 |
$0.00 |
| 90710 |
|
111 |
111 |
$0.00 |
| 90670 |
|
21 |
21 |
$0.00 |
| 90681 |
|
25 |
25 |
$0.00 |