| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,394 |
4,183 |
$334K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,339 |
1,275 |
$59K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
130 |
119 |
$14K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
94 |
86 |
$10K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
378 |
367 |
$9K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
56 |
56 |
$7K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
26 |
26 |
$3K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
290 |
142 |
$3K |
| 99173 |
|
340 |
326 |
$2K |
| 99177 |
|
16 |
16 |
$270.00 |
| 90686 |
|
839 |
813 |
$104.49 |
| 81002 |
|
924 |
872 |
$41.00 |
| 99000 |
|
56 |
51 |
$0.00 |
| 90461 |
|
150 |
145 |
$0.00 |
| 90685 |
|
46 |
46 |
$0.00 |