| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,271 |
1,097 |
$100K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
724 |
599 |
$62K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
154 |
152 |
$15K |
| 90686 |
|
580 |
563 |
$12K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
69 |
66 |
$7K |
| 99381 |
|
38 |
37 |
$4K |
| 90698 |
|
93 |
88 |
$2K |
| 90670 |
|
84 |
82 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
12 |
12 |
$2K |
| 90744 |
|
62 |
56 |
$1K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
535 |
505 |
$1K |
| 90680 |
|
36 |
36 |
$744.96 |
| 90461 |
|
115 |
111 |
$551.32 |
| 90656 |
|
21 |
21 |
$488.88 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
15 |
13 |
$197.10 |
| 84030 |
|
16 |
13 |
$27.00 |
| 36416 |
|
16 |
14 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
32 |
32 |
$0.00 |