| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0002A |
|
15 |
15 |
$457.00 |
| 0001A |
|
13 |
13 |
$221.00 |
| 91300 |
|
78 |
67 |
$0.76 |
| 91301 |
|
64 |
61 |
$0.21 |
| 99484 |
|
157 |
152 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
8,766 |
7,598 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,376 |
1,263 |
$0.00 |
| 99308 |
Subsequent nursing facility care, per day, straightforward |
71 |
54 |
$0.00 |
| 0012A |
|
15 |
15 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
45 |
45 |
$0.00 |
| 0011A |
|
15 |
15 |
$0.00 |
| 96127 |
|
20 |
18 |
$0.00 |
| 90686 |
|
32 |
32 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
936 |
862 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
99 |
98 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
42 |
40 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
12 |
12 |
$0.00 |
| 99490 |
Ccm add 20min |
120 |
116 |
$0.00 |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
15 |
14 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
28 |
28 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
15 |
15 |
$0.00 |