| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,376 |
5,050 |
$455K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,197 |
2,080 |
$56K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
278 |
273 |
$22K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
250 |
231 |
$21K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
239 |
233 |
$14K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
48 |
42 |
$4K |
| 90686 |
|
484 |
465 |
$4K |
| 90461 |
|
144 |
140 |
$3K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
161 |
151 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
263 |
240 |
$3K |
| G0008 |
Administration of influenza virus vaccine |
106 |
106 |
$1K |
| 36415 |
Collection of venous blood by venipuncture |
83 |
81 |
$334.50 |
| 81000 |
|
77 |
76 |
$163.73 |
| 97803 |
|
515 |
457 |
$49.56 |