| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,294 |
4,406 |
$233K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
461 |
430 |
$41K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
186 |
184 |
$19K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
794 |
717 |
$19K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
141 |
141 |
$18K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
67 |
64 |
$6K |
| 92552 |
|
581 |
560 |
$4K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
151 |
147 |
$4K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
41 |
41 |
$3K |
| 81003 |
|
733 |
700 |
$531.27 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
157 |
78 |
$294.24 |
| 99442 |
|
15 |
15 |
$291.75 |
| 99188 |
|
117 |
114 |
$285.65 |
| 90461 |
|
140 |
139 |
$120.00 |
| 90670 |
|
39 |
39 |
$0.08 |
| 90700 |
|
91 |
91 |
$0.02 |
| 90633 |
|
26 |
26 |
$0.01 |
| 90713 |
|
54 |
54 |
$0.01 |
| 90648 |
|
42 |
42 |
$0.01 |
| 90716 |
|
39 |
39 |
$0.01 |
| 90649 |
|
39 |
39 |
$0.00 |
| 90734 |
|
15 |
15 |
$0.00 |
| 99173 |
|
237 |
237 |
$0.00 |