| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,307 |
1,153 |
$66K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
667 |
593 |
$48K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
675 |
654 |
$21K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
554 |
526 |
$21K |
| 99441 |
|
334 |
309 |
$12K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
99 |
99 |
$7K |
| 90756 |
|
372 |
367 |
$5K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
150 |
149 |
$4K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
54 |
54 |
$4K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
70 |
70 |
$3K |
| 99442 |
|
23 |
21 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
87 |
83 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12 |
12 |
$888.00 |
| T1013 |
Sign language or oral interpretive services, per 15 minutes |
48 |
36 |
$242.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
33 |
33 |
$190.30 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
36 |
35 |
$169.65 |
| 90461 |
|
13 |
13 |
$168.19 |
| 36415 |
Collection of venous blood by venipuncture |
106 |
100 |
$2.55 |
| V5008 |
Hearing screening |
27 |
27 |
$0.00 |
| 2010F |
|
16 |
15 |
$0.00 |