| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,852 |
2,429 |
$106K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,072 |
970 |
$59K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
235 |
170 |
$15K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
383 |
367 |
$10K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
106 |
97 |
$9K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
754 |
723 |
$7K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
93 |
88 |
$7K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
310 |
285 |
$5K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
46 |
44 |
$4K |
| 90686 |
|
248 |
233 |
$3K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
42 |
37 |
$1K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
13 |
12 |
$977.25 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
13 |
13 |
$939.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
27 |
25 |
$777.91 |
| 36415 |
Collection of venous blood by venipuncture |
252 |
233 |
$723.03 |
| 81025 |
|
40 |
39 |
$350.83 |
| 81002 |
|
189 |
170 |
$328.32 |
| 90734 |
|
26 |
26 |
$118.58 |
| 90715 |
|
13 |
12 |
$113.03 |
| 90651 |
|
35 |
34 |
$0.00 |
| 90633 |
|
53 |
50 |
$0.00 |
| 90670 |
|
43 |
38 |
$0.00 |
| 90648 |
|
25 |
25 |
$0.00 |
| 90685 |
|
47 |
46 |
$0.00 |