| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
640 |
598 |
$42K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
250 |
236 |
$24K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
424 |
420 |
$23K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
193 |
180 |
$18K |
| 99058 |
|
403 |
391 |
$7K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
69 |
69 |
$7K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
172 |
168 |
$3K |
| 92567 |
|
255 |
236 |
$3K |
| 94010 |
|
93 |
88 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
274 |
263 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
16 |
16 |
$2K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
18 |
18 |
$1K |
| 92015 |
Determination of refractive state |
147 |
143 |
$554.85 |
| 36416 |
|
50 |
50 |
$193.19 |
| 92587 |
|
142 |
141 |
$144.96 |
| 90700 |
|
84 |
84 |
$0.00 |
| 90670 |
|
61 |
61 |
$0.00 |
| 90713 |
|
59 |
59 |
$0.00 |
| 90648 |
|
60 |
60 |
$0.00 |
| 90685 |
|
50 |
50 |
$0.00 |
| 90686 |
|
113 |
111 |
$0.00 |
| 90680 |
|
13 |
13 |
$0.00 |