| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,138 |
746 |
$52K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
719 |
607 |
$50K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
219 |
145 |
$15K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
91 |
69 |
$7K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
74 |
69 |
$6K |
| 90686 |
|
483 |
370 |
$4K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
44 |
44 |
$3K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
42 |
25 |
$3K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
29 |
28 |
$1K |
| 90621 |
|
34 |
12 |
$668.87 |
| 90619 |
|
40 |
12 |
$636.75 |
| 90651 |
|
16 |
13 |
$102.40 |
| 81003 |
|
18 |
13 |
$37.06 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
789 |
502 |
$0.00 |
| 90461 |
|
184 |
110 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
45 |
38 |
$0.00 |