| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
376 |
348 |
$22K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
143 |
137 |
$13K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
68 |
67 |
$4K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
13 |
13 |
$1K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
30 |
30 |
$1K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
14 |
13 |
$1K |
| 94760 |
|
196 |
186 |
$460.62 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
32 |
30 |
$394.93 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
15 |
15 |
$393.73 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
29 |
13 |
$80.00 |
| 36416 |
|
12 |
12 |
$45.22 |
| 87999 |
|
32 |
30 |
$37.20 |
| 97803 |
|
67 |
63 |
$0.00 |
| 99000 |
|
16 |
15 |
$0.00 |