| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
9,768 |
8,923 |
$746K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,014 |
2,948 |
$323K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,456 |
1,456 |
$141K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
533 |
533 |
$78K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
908 |
901 |
$28K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
187 |
187 |
$19K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
169 |
169 |
$16K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
66 |
66 |
$6K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
34 |
34 |
$3K |
| 99383 |
|
21 |
21 |
$2K |
| 99384 |
|
16 |
16 |
$2K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
17 |
17 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
39 |
39 |
$1K |
| 90674 |
|
15 |
15 |
$27.37 |
| 90756 |
|
21 |
21 |
$24.96 |
| 90715 |
|
14 |
14 |
$0.00 |
| 90734 |
|
34 |
34 |
$0.00 |
| 96160 |
|
295 |
295 |
$0.00 |
| 90686 |
|
52 |
52 |
$0.00 |