| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,626 |
1,415 |
$74K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
226 |
214 |
$18K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
74 |
72 |
$7K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
26 |
24 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
26 |
25 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
13 |
12 |
$381.29 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
94 |
84 |
$370.76 |
| H2010 |
Comprehensive medication services, per 15 minutes |
17 |
13 |
$300.00 |
| 90686 |
|
242 |
241 |
$209.02 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
539 |
536 |
$135.04 |
| 92587 |
|
85 |
84 |
$75.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
28 |
13 |
$47.64 |
| 90670 |
|
24 |
24 |
$10.00 |
| 3008F |
|
483 |
436 |
$0.00 |
| 3074F |
|
269 |
258 |
$0.00 |
| 1036F |
|
20 |
14 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
193 |
190 |
$0.00 |
| 1160F |
|
80 |
63 |
$0.00 |
| 3078F |
|
243 |
233 |
$0.00 |
| 90648 |
|
12 |
12 |
$0.00 |