| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,977 |
1,684 |
$86K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,046 |
1,003 |
$67K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,640 |
1,133 |
$39K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
407 |
404 |
$23K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
378 |
357 |
$20K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
318 |
312 |
$17K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
90 |
90 |
$6K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
330 |
323 |
$4K |
| 99051 |
|
162 |
156 |
$3K |
| 90670 |
|
274 |
270 |
$820.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
56 |
56 |
$662.43 |
| 90686 |
|
203 |
202 |
$500.00 |
| 90633 |
|
111 |
109 |
$450.00 |
| 90698 |
|
92 |
89 |
$280.00 |
| 90744 |
|
46 |
43 |
$160.00 |
| 90672 |
|
28 |
28 |
$110.00 |
| 90680 |
|
26 |
26 |
$100.00 |
| 90651 |
|
40 |
38 |
$100.00 |
| 90710 |
|
27 |
26 |
$90.00 |
| 90685 |
|
28 |
28 |
$80.00 |
| 90734 |
|
29 |
27 |
$70.00 |
| 90723 |
|
17 |
17 |
$70.00 |
| 90648 |
|
22 |
22 |
$60.00 |
| 90696 |
|
13 |
12 |
$40.00 |