| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
7,444 |
6,416 |
$192K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
3,847 |
3,725 |
$73K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,184 |
1,164 |
$66K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
956 |
944 |
$48K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
596 |
555 |
$36K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
453 |
451 |
$23K |
| 92552 |
|
1,339 |
1,307 |
$19K |
| 90461 |
|
854 |
846 |
$15K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
139 |
136 |
$7K |
| 90658 |
|
1,045 |
1,031 |
$7K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
65 |
65 |
$4K |
| 90651 |
|
26 |
26 |
$1K |
| 99384 |
|
12 |
12 |
$945.54 |
| 90670 |
|
53 |
51 |
$378.75 |
| 96127 |
|
393 |
385 |
$356.73 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
29 |
27 |
$217.84 |
| 90619 |
|
12 |
12 |
$150.00 |
| 99173 |
|
57 |
57 |
$136.74 |
| 90657 |
|
82 |
82 |
$70.41 |
| 97803 |
|
17 |
17 |
$0.00 |