| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,101 |
3,344 |
$148K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,379 |
935 |
$45K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
358 |
304 |
$21K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
232 |
203 |
$13K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
279 |
225 |
$13K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
476 |
392 |
$11K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
176 |
148 |
$10K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
824 |
335 |
$8K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
711 |
625 |
$7K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
68 |
54 |
$4K |
| 99381 |
|
19 |
13 |
$802.84 |
| 90670 |
|
393 |
298 |
$501.86 |
| 90686 |
|
322 |
255 |
$218.25 |
| 96127 |
|
33 |
29 |
$172.24 |
| 81003 |
|
80 |
72 |
$154.91 |
| 90648 |
|
249 |
177 |
$40.30 |
| 90633 |
|
42 |
39 |
$0.00 |
| 90707 |
|
38 |
25 |
$0.00 |
| 99072 |
|
31 |
20 |
$0.00 |
| 90723 |
|
174 |
135 |
$0.00 |
| 90680 |
|
99 |
80 |
$0.00 |
| 90716 |
|
33 |
27 |
$0.00 |
| 90647 |
|
90 |
69 |
$0.00 |