| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,804 |
1,424 |
$106K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
373 |
345 |
$32K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
662 |
651 |
$15K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
153 |
153 |
$13K |
| 92587 |
|
591 |
591 |
$12K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
25 |
25 |
$2K |
| 85018 |
|
714 |
714 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
14 |
14 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
30 |
30 |
$1K |
| 81002 |
|
467 |
456 |
$933.53 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
181 |
162 |
$714.10 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
41 |
21 |
$580.00 |
| 86580 |
|
42 |
42 |
$344.95 |
| 36415 |
Collection of venous blood by venipuncture |
74 |
74 |
$5.00 |
| 36416 |
|
99 |
99 |
$0.00 |
| 90686 |
|
27 |
27 |
$0.00 |