| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
296 |
275 |
$13K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
133 |
129 |
$8K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
223 |
206 |
$5K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
34 |
33 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
19 |
17 |
$1K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
59 |
55 |
$955.40 |
| 99058 |
|
36 |
36 |
$644.84 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
20 |
20 |
$415.52 |
| 99490 |
Ccm add 20min |
14 |
14 |
$232.11 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
20 |
20 |
$178.32 |
| 92015 |
Determination of refractive state |
21 |
21 |
$48.60 |
| 92587 |
|
21 |
21 |
$14.38 |
| 90686 |
|
21 |
21 |
$0.00 |