| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,133 |
1,569 |
$134K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,777 |
1,861 |
$119K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
211 |
113 |
$15K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
179 |
121 |
$13K |
| 90670 |
|
178 |
103 |
$11K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
126 |
96 |
$10K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
114 |
82 |
$8K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
151 |
123 |
$3K |
| 90700 |
|
194 |
97 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
156 |
142 |
$2K |
| 90713 |
|
115 |
63 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
26 |
26 |
$2K |
| 90680 |
|
32 |
12 |
$2K |
| 90756 |
|
57 |
29 |
$1K |
| 90648 |
|
138 |
67 |
$1K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
410 |
232 |
$920.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
12 |
12 |
$449.20 |
| 36415 |
Collection of venous blood by venipuncture |
1,295 |
848 |
$430.50 |
| 90658 |
|
60 |
24 |
$412.16 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
49 |
26 |
$200.00 |
| 82962 |
|
94 |
60 |
$154.00 |
| 90686 |
|
20 |
15 |
$134.23 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
74 |
32 |
$110.09 |
| 90716 |
|
13 |
12 |
$81.28 |
| 94760 |
|
28 |
17 |
$55.15 |
| 90461 |
|
121 |
80 |
$20.00 |
| G8754 |
Most recent diastolic blood pressure < 90 mmhg |
49 |
42 |
$0.00 |
| 3008F |
|
40 |
28 |
$0.00 |
| G8752 |
Most recent systolic blood pressure < 140 mmhg |
75 |
66 |
$0.00 |