| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,861 |
1,724 |
$129K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,651 |
2,443 |
$120K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
922 |
897 |
$82K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
680 |
590 |
$58K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
288 |
282 |
$27K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
223 |
198 |
$20K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,184 |
2,112 |
$17K |
| 90461 |
|
1,081 |
1,013 |
$4K |
| 90688 |
|
182 |
165 |
$1K |
| 90670 |
|
263 |
237 |
$944.06 |
| 92552 |
|
92 |
83 |
$900.06 |
| 0071A |
|
24 |
12 |
$440.00 |
| 90633 |
|
43 |
43 |
$278.57 |
| 90687 |
|
75 |
70 |
$253.24 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
120 |
76 |
$240.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
50 |
49 |
$109.16 |
| 99173 |
|
284 |
263 |
$100.00 |
| 90723 |
|
37 |
37 |
$60.00 |
| 90647 |
|
107 |
92 |
$48.02 |
| 90707 |
|
29 |
28 |
$24.01 |
| 90696 |
|
12 |
12 |
$24.01 |
| 90716 |
|
29 |
28 |
$24.01 |
| 90686 |
|
66 |
65 |
$17.97 |
| 90734 |
|
14 |
14 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
80 |
70 |
$0.00 |
| 91307 |
|
27 |
13 |
$0.00 |