| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,902 |
2,575 |
$103K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
655 |
628 |
$51K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
502 |
476 |
$37K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
220 |
211 |
$16K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
938 |
919 |
$9K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
506 |
496 |
$7K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
144 |
141 |
$6K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
292 |
285 |
$2K |
| 90715 |
|
77 |
77 |
$892.63 |
| 90734 |
|
73 |
73 |
$884.56 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
36 |
35 |
$458.70 |
| 90656 |
|
215 |
208 |
$155.21 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
14 |
14 |
$137.57 |
| 90688 |
|
33 |
33 |
$17.16 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
13 |
13 |
$6.01 |
| 90723 |
|
26 |
25 |
$0.00 |