| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
759 |
674 |
$37K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
241 |
239 |
$15K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
720 |
701 |
$11K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
100 |
100 |
$7K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
74 |
72 |
$5K |
| 92015 |
Determination of refractive state |
63 |
63 |
$598.94 |
| D0190 |
|
179 |
179 |
$417.04 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
14 |
14 |
$123.39 |
| 99051 |
|
13 |
13 |
$45.00 |
| 96127 |
|
12 |
12 |
$41.55 |
| 90685 |
|
30 |
30 |
$0.00 |
| 90670 |
|
53 |
52 |
$0.00 |
| 99177 |
|
28 |
28 |
$0.00 |
| 90633 |
|
14 |
14 |
$0.00 |
| 90461 |
|
13 |
12 |
$0.00 |
| 90688 |
|
31 |
31 |
$0.00 |
| 90698 |
|
27 |
26 |
$0.00 |
| 90686 |
|
16 |
16 |
$0.00 |