| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,004 |
3,298 |
$239K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,574 |
2,174 |
$205K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
856 |
775 |
$75K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
804 |
722 |
$74K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,133 |
2,118 |
$55K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
588 |
549 |
$51K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
216 |
215 |
$20K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
973 |
896 |
$9K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
14 |
14 |
$1K |
| 99215 |
Prolong outpt/office vis |
16 |
13 |
$1K |
| 90658 |
|
137 |
136 |
$908.60 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
26 |
26 |
$624.26 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
24 |
24 |
$288.00 |
| 90461 |
|
19 |
19 |
$228.00 |
| 99173 |
|
1,029 |
868 |
$146.38 |
| 97803 |
|
460 |
353 |
$77.87 |
| 90716 |
|
28 |
28 |
$72.00 |
| 90723 |
|
115 |
113 |
$0.00 |
| 92551 |
|
1,141 |
965 |
$0.00 |
| 90680 |
|
88 |
86 |
$0.00 |
| 90670 |
|
280 |
277 |
$0.00 |
| 90648 |
|
300 |
298 |
$0.00 |
| 90707 |
|
12 |
12 |
$0.00 |
| 90633 |
|
31 |
31 |
$0.00 |