| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,062 |
2,879 |
$194K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,653 |
1,587 |
$146K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,017 |
905 |
$88K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,290 |
1,282 |
$52K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
348 |
348 |
$31K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
101 |
101 |
$6K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
26 |
26 |
$4K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
39 |
39 |
$3K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
50 |
50 |
$726.90 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
31 |
31 |
$584.42 |
| 90686 |
|
55 |
55 |
$1.00 |
| 90647 |
|
116 |
116 |
$0.00 |
| 90723 |
|
28 |
28 |
$0.00 |
| 90670 |
|
325 |
324 |
$0.00 |
| 90734 |
|
12 |
12 |
$0.00 |
| 90633 |
|
14 |
14 |
$0.00 |