| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
560 |
477 |
$30K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
153 |
143 |
$14K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
138 |
127 |
$12K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
113 |
110 |
$9K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
232 |
199 |
$8K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
82 |
70 |
$7K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
56 |
55 |
$5K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
159 |
137 |
$4K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
323 |
273 |
$3K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
46 |
19 |
$594.92 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
31 |
28 |
$392.12 |
| 81002 |
|
94 |
86 |
$306.48 |
| 90670 |
|
17 |
17 |
$0.00 |
| 90715 |
|
15 |
12 |
$0.00 |
| 90734 |
|
16 |
13 |
$0.00 |