| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
10,543 |
9,178 |
$283K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,786 |
1,559 |
$39K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
559 |
497 |
$28K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
449 |
406 |
$22K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
361 |
344 |
$19K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
167 |
156 |
$9K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
105 |
94 |
$5K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
220 |
193 |
$4K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
347 |
307 |
$3K |
| 71046 |
Radiologic examination, chest; 2 views |
106 |
91 |
$2K |
| 99215 |
Prolong outpt/office vis |
15 |
13 |
$1K |
| 99307 |
|
65 |
62 |
$1K |
| 71020 |
|
28 |
26 |
$903.16 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
26 |
25 |
$244.20 |
| 90686 |
|
27 |
25 |
$191.41 |
| 83655 |
|
13 |
12 |
$190.08 |
| 81001 |
|
62 |
39 |
$126.74 |
| 0011A |
|
15 |
12 |
$120.00 |
| G0008 |
Administration of influenza virus vaccine |
32 |
28 |
$75.00 |
| 99441 |
|
26 |
18 |
$21.98 |
| 99442 |
|
33 |
22 |
$0.00 |