| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,406 |
2,368 |
$269K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,344 |
1,812 |
$136K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,833 |
2,224 |
$76K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
196 |
157 |
$14K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
226 |
185 |
$7K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
50 |
39 |
$4K |
| 92551 |
|
701 |
556 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
56 |
30 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
29 |
25 |
$3K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
368 |
174 |
$2K |
| 99215 |
Prolong outpt/office vis |
15 |
13 |
$2K |
| 99173 |
|
303 |
217 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
103 |
86 |
$961.80 |
| 86403 |
|
134 |
68 |
$574.07 |
| 94760 |
|
386 |
270 |
$488.04 |
| 96127 |
|
99 |
62 |
$468.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
17 |
16 |
$283.35 |
| 36416 |
|
112 |
87 |
$277.60 |
| 87807 |
|
15 |
13 |
$137.40 |
| 90686 |
|
690 |
582 |
$21.56 |
| 85018 |
|
128 |
87 |
$4.52 |
| 99000 |
|
421 |
321 |
$0.00 |
| 90698 |
|
15 |
13 |
$0.00 |
| 90656 |
|
129 |
78 |
$0.00 |
| 90685 |
|
30 |
30 |
$0.00 |
| 90670 |
|
44 |
37 |
$0.00 |
| 90461 |
|
48 |
36 |
$0.00 |