| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,099 |
2,762 |
$126K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
597 |
563 |
$34K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,675 |
1,453 |
$32K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
252 |
252 |
$24K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
164 |
164 |
$14K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
863 |
831 |
$13K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
65 |
65 |
$6K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
382 |
187 |
$6K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
12 |
12 |
$1K |
| 0071A |
|
26 |
26 |
$1K |
| 99050 |
|
55 |
53 |
$904.54 |
| 0072A |
|
23 |
23 |
$588.08 |
| 90461 |
|
142 |
113 |
$504.52 |
| 96160 |
|
142 |
141 |
$324.14 |
| 92551 |
|
550 |
542 |
$242.96 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
15 |
14 |
$236.10 |
| 90686 |
|
509 |
508 |
$96.37 |
| 90672 |
|
18 |
18 |
$27.85 |
| 90656 |
|
85 |
85 |
$0.00 |
| 90674 |
|
18 |
18 |
$0.00 |
| 91307 |
|
73 |
69 |
$0.00 |
| 90660 |
|
20 |
20 |
$0.00 |
| 99173 |
|
940 |
931 |
$0.00 |
| 90670 |
|
12 |
12 |
$0.00 |