| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
481 |
444 |
$36K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
114 |
114 |
$12K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
102 |
100 |
$11K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
74 |
74 |
$7K |
| 90461 |
|
175 |
175 |
$4K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
260 |
260 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
12 |
12 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
39 |
20 |
$542.40 |
| 81003 |
|
101 |
99 |
$204.00 |
| 85018 |
|
89 |
89 |
$191.35 |
| 90633 |
|
14 |
14 |
$0.00 |
| 90670 |
|
77 |
77 |
$0.00 |
| 90707 |
|
14 |
14 |
$0.00 |
| 90686 |
|
115 |
115 |
$0.00 |
| 90716 |
|
14 |
14 |
$0.00 |
| 90647 |
|
17 |
17 |
$0.00 |
| 90680 |
|
12 |
12 |
$0.00 |
| 90723 |
|
37 |
37 |
$0.00 |