| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,215 |
2,017 |
$110K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
410 |
386 |
$26K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
234 |
229 |
$24K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
150 |
147 |
$13K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
103 |
103 |
$11K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,105 |
745 |
$10K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
27 |
25 |
$3K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
45 |
45 |
$1K |
| 90686 |
|
112 |
112 |
$321.88 |
| 90672 |
|
57 |
57 |
$135.00 |
| 90688 |
|
37 |
37 |
$91.82 |
| 92551 |
|
13 |
13 |
$36.78 |
| 99174 |
|
14 |
14 |
$24.76 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
25 |
24 |
$20.70 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
64 |
59 |
$0.00 |