| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
958 |
881 |
$40K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
278 |
267 |
$15K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
929 |
887 |
$14K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
93 |
89 |
$5K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
72 |
71 |
$4K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
39 |
38 |
$2K |
| 90461 |
|
43 |
42 |
$905.93 |
| 90686 |
|
51 |
49 |
$537.07 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
27 |
13 |
$222.72 |
| 99173 |
|
134 |
134 |
$189.99 |
| 87430 |
|
58 |
56 |
$141.17 |
| 36415 |
Collection of venous blood by venipuncture |
37 |
37 |
$82.50 |
| 99000 |
|
12 |
12 |
$0.00 |