| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
7,791 |
7,371 |
$236K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
296 |
287 |
$11K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
516 |
408 |
$10K |
| 90686 |
|
591 |
577 |
$6K |
| 99080 |
|
252 |
246 |
$5K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
287 |
244 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
311 |
305 |
$3K |
| 92587 |
|
116 |
90 |
$2K |
| 99173 |
|
472 |
411 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
127 |
114 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
110 |
96 |
$1K |
| 90688 |
|
164 |
163 |
$966.37 |
| 90656 |
|
122 |
121 |
$710.86 |
| 0071A |
|
14 |
14 |
$590.00 |
| 90461 |
|
19 |
13 |
$545.11 |
| 90670 |
|
26 |
26 |
$328.25 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
26 |
13 |
$324.74 |
| 90698 |
|
24 |
24 |
$315.12 |
| 90680 |
|
24 |
24 |
$301.99 |
| 96127 |
|
50 |
50 |
$197.60 |
| 99177 |
|
12 |
12 |
$126.04 |
| 87081 |
|
38 |
37 |
$112.58 |
| 99000 |
|
153 |
147 |
$20.16 |
| 90619 |
|
12 |
12 |
$0.00 |
| 36416 |
|
16 |
14 |
$0.00 |
| 90716 |
|
12 |
12 |
$0.00 |