| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,284 |
3,923 |
$234K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,848 |
2,667 |
$226K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
3,261 |
3,235 |
$172K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
248 |
248 |
$17K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
161 |
161 |
$11K |
| 90461 |
|
107 |
107 |
$7K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
68 |
68 |
$5K |
| 87430 |
|
267 |
254 |
$3K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
161 |
80 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
25 |
24 |
$2K |
| 0072A |
|
17 |
17 |
$912.60 |
| 0071A |
|
14 |
14 |
$778.40 |
| 90670 |
|
13 |
13 |
$0.00 |
| 90686 |
|
1,083 |
1,083 |
$0.00 |
| 90656 |
|
113 |
113 |
$0.00 |
| 91307 |
|
42 |
42 |
$0.00 |