| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,511 |
3,185 |
$246K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
511 |
511 |
$46K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
276 |
264 |
$28K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
312 |
312 |
$28K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
211 |
211 |
$21K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,425 |
2,384 |
$20K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
188 |
188 |
$18K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
185 |
175 |
$16K |
| 99443 |
|
147 |
132 |
$11K |
| 92551 |
|
1,346 |
1,346 |
$8K |
| 96127 |
|
326 |
326 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
74 |
36 |
$1K |
| 90686 |
|
578 |
578 |
$151.95 |
| 90633 |
|
12 |
12 |
$39.80 |
| 90461 |
|
507 |
504 |
$0.00 |
| 90685 |
|
12 |
12 |
$0.00 |
| 90670 |
|
73 |
73 |
$0.00 |
| 90696 |
|
12 |
12 |
$0.00 |
| 90698 |
|
61 |
61 |
$0.00 |