| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,123 |
1,997 |
$154K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,034 |
1,892 |
$102K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
235 |
206 |
$15K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
203 |
203 |
$15K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
109 |
109 |
$8K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
924 |
911 |
$6K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
468 |
464 |
$6K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
32 |
32 |
$3K |
| 99215 |
Prolong outpt/office vis |
24 |
24 |
$3K |
| 90686 |
|
205 |
202 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
75 |
75 |
$947.32 |
| 90682 |
|
15 |
15 |
$748.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
45 |
45 |
$676.52 |
| 90715 |
|
38 |
37 |
$623.13 |
| 81003 |
|
362 |
319 |
$575.67 |
| 99051 |
|
62 |
60 |
$322.80 |
| 81025 |
|
13 |
13 |
$78.08 |
| 90670 |
|
156 |
156 |
$0.00 |
| 90710 |
|
12 |
12 |
$0.00 |
| 90648 |
|
12 |
12 |
$0.00 |
| 90685 |
|
29 |
29 |
$0.00 |
| 90633 |
|
67 |
67 |
$0.00 |
| 90707 |
|
13 |
13 |
$0.00 |
| 1220F |
|
240 |
238 |
$0.00 |
| 90698 |
|
53 |
53 |
$0.00 |
| 90680 |
|
13 |
13 |
$0.00 |
| 90716 |
|
12 |
12 |
$0.00 |
| 90744 |
|
12 |
12 |
$0.00 |