| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,951 |
3,289 |
$222K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,537 |
1,491 |
$66K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
426 |
423 |
$29K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
413 |
390 |
$26K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
377 |
339 |
$22K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
217 |
217 |
$16K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
184 |
166 |
$13K |
| 97802 |
|
1,021 |
1,001 |
$12K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
253 |
241 |
$9K |
| 99173 |
|
433 |
432 |
$4K |
| 98960 |
|
1,294 |
1,271 |
$4K |
| 90461 |
|
77 |
77 |
$4K |
| 99215 |
Prolong outpt/office vis |
16 |
13 |
$2K |
| 81002 |
|
752 |
742 |
$1K |
| 90670 |
|
90 |
80 |
$1K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
16 |
16 |
$522.61 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
16 |
16 |
$82.00 |
| 90686 |
|
244 |
242 |
$74.10 |
| 90723 |
|
15 |
15 |
$0.00 |
| 90633 |
|
12 |
12 |
$0.00 |
| 90734 |
|
17 |
17 |
$0.00 |
| 90648 |
|
47 |
45 |
$0.00 |
| 90681 |
|
13 |
13 |
$0.00 |