| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
787 |
686 |
$38K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
287 |
268 |
$22K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
149 |
132 |
$12K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
145 |
134 |
$11K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
88 |
82 |
$7K |
| 90686 |
|
231 |
216 |
$3K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
32 |
26 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
49 |
47 |
$1K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
75 |
70 |
$925.04 |
| 90688 |
|
92 |
87 |
$582.40 |
| 99460 |
|
15 |
14 |
$544.44 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
26 |
25 |
$408.20 |
| 96127 |
|
26 |
25 |
$374.80 |
| 90670 |
|
20 |
12 |
$301.00 |
| 90648 |
|
13 |
13 |
$217.23 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
356 |
304 |
$51.00 |
| T1015 |
Clinic visit/encounter, all-inclusive |
58 |
52 |
$0.00 |
| 1003F |
|
150 |
119 |
$0.00 |
| 90461 |
|
83 |
64 |
$0.00 |