| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,231 |
2,023 |
$82K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
104 |
104 |
$10K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
123 |
119 |
$6K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
52 |
52 |
$4K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
27 |
27 |
$2K |
| 92551 |
|
426 |
420 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
25 |
25 |
$2K |
| 90686 |
|
74 |
71 |
$1K |
| 99173 |
|
287 |
283 |
$940.20 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
42 |
39 |
$933.20 |
| 90670 |
|
129 |
128 |
$811.00 |
| 90698 |
|
66 |
63 |
$649.00 |
| 90688 |
|
65 |
65 |
$362.75 |
| 96127 |
|
42 |
42 |
$158.40 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
16 |
16 |
$110.88 |
| 90680 |
|
15 |
15 |
$84.00 |
| 96160 |
|
13 |
13 |
$44.91 |
| 90697 |
|
13 |
13 |
$0.00 |