| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,427 |
2,135 |
$141K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,658 |
2,512 |
$128K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
619 |
384 |
$36K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
272 |
223 |
$25K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
197 |
123 |
$10K |
| 97802 |
|
1,656 |
1,124 |
$7K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,801 |
1,136 |
$4K |
| 99401 |
|
1,441 |
945 |
$3K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
14 |
12 |
$1K |
| 92552 |
|
607 |
370 |
$1K |
| 90461 |
|
550 |
278 |
$1K |
| 90656 |
|
20 |
18 |
$0.00 |
| 90686 |
|
75 |
67 |
$0.00 |
| 99173 |
|
1,197 |
727 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
26 |
15 |
$0.00 |