| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,676 |
1,509 |
$45K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
375 |
357 |
$20K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
445 |
380 |
$20K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
410 |
349 |
$19K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
369 |
323 |
$18K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
369 |
322 |
$18K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
546 |
284 |
$6K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
204 |
188 |
$4K |
| 87430 |
|
266 |
245 |
$3K |
| 90686 |
|
260 |
246 |
$3K |
| 83655 |
|
130 |
125 |
$2K |
| 90670 |
|
220 |
211 |
$2K |
| 90723 |
|
121 |
116 |
$1K |
| 90651 |
|
114 |
100 |
$908.20 |
| 90734 |
|
104 |
87 |
$793.48 |
| 87807 |
|
43 |
43 |
$559.43 |
| 90658 |
|
35 |
33 |
$314.04 |
| 90647 |
|
31 |
31 |
$296.36 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
31 |
28 |
$270.80 |
| 90710 |
|
34 |
28 |
$258.12 |
| 90633 |
|
28 |
27 |
$248.56 |
| 90680 |
|
25 |
24 |
$229.44 |
| 90685 |
|
24 |
20 |
$191.20 |
| 90715 |
|
22 |
16 |
$152.96 |
| 90688 |
|
12 |
12 |
$105.16 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
49 |
47 |
$0.00 |
| Q2036 |
Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (flulaval) |
45 |
39 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
217 |
203 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
64 |
59 |
$0.00 |