| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,946 |
1,775 |
$399K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,093 |
1,021 |
$243K |
| T1015 |
Clinic visit/encounter, all-inclusive |
1,031 |
860 |
$85K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
199 |
199 |
$42K |
| 87428 |
|
684 |
661 |
$42K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
94 |
93 |
$19K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
72 |
72 |
$14K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
337 |
337 |
$6K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
15 |
13 |
$4K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
483 |
460 |
$847.73 |
| 90651 |
|
84 |
84 |
$448.32 |
| 87807 |
|
56 |
55 |
$98.17 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
42 |
42 |
$90.84 |
| 3078F |
|
73 |
72 |
$54.40 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
13 |
12 |
$8.68 |
| 90633 |
|
58 |
57 |
$0.00 |
| 90707 |
|
25 |
25 |
$0.00 |
| 90461 |
|
75 |
75 |
$0.00 |
| 90670 |
|
13 |
13 |
$0.00 |
| 90715 |
|
39 |
39 |
$0.00 |
| 90734 |
|
40 |
40 |
$0.00 |
| 3074F |
|
58 |
56 |
$0.00 |
| 90686 |
|
95 |
95 |
$0.00 |
| 3008F |
|
82 |
73 |
$0.00 |
| 90656 |
|
15 |
15 |
$0.00 |
| 90696 |
|
12 |
12 |
$0.00 |
| 90716 |
|
25 |
25 |
$0.00 |
| 90677 |
|
13 |
13 |
$0.00 |