| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
6,384 |
5,236 |
$233K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,352 |
2,887 |
$120K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
527 |
433 |
$37K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
427 |
417 |
$34K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,800 |
1,662 |
$17K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
187 |
185 |
$14K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
63 |
63 |
$5K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
396 |
353 |
$3K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
236 |
151 |
$2K |
| 90461 |
|
834 |
764 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
14 |
14 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
13 |
13 |
$431.22 |
| 90670 |
|
226 |
211 |
$380.00 |
| 90656 |
|
105 |
105 |
$326.34 |
| 90633 |
|
27 |
24 |
$154.06 |
| 90698 |
|
13 |
13 |
$150.00 |
| 90621 |
|
16 |
14 |
$30.00 |
| 90710 |
|
12 |
12 |
$20.00 |
| G8483 |
Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons) |
139 |
116 |
$0.00 |
| 90688 |
|
31 |
26 |
$0.00 |
| 90686 |
|
17 |
17 |
$0.00 |