| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,190 |
4,630 |
$185K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
259 |
238 |
$19K |
| 99000 |
|
2,135 |
1,597 |
$19K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,711 |
781 |
$14K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
151 |
137 |
$12K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
948 |
921 |
$9K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
179 |
168 |
$9K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
534 |
260 |
$7K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
451 |
436 |
$6K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
78 |
75 |
$6K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
100 |
89 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
26 |
24 |
$2K |
| 90461 |
|
280 |
227 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
74 |
73 |
$679.48 |
| 81000 |
|
47 |
42 |
$141.96 |
| 90686 |
|
374 |
369 |
$0.87 |
| 90672 |
|
17 |
17 |
$0.03 |
| 90651 |
|
14 |
13 |
$0.02 |
| 90648 |
|
24 |
24 |
$0.00 |
| 90670 |
|
12 |
12 |
$0.00 |
| 99072 |
|
41 |
35 |
$0.00 |