| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
969 |
954 |
$36K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
918 |
912 |
$11K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
92 |
92 |
$7K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
78 |
77 |
$6K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
52 |
52 |
$4K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
386 |
385 |
$4K |
| 90686 |
|
350 |
349 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
29 |
29 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
13 |
13 |
$1K |
| 90633 |
|
27 |
27 |
$478.40 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
26 |
26 |
$436.25 |
| 90734 |
|
13 |
13 |
$239.20 |
| 90685 |
|
26 |
26 |
$239.20 |
| 90651 |
|
12 |
12 |
$220.80 |
| 90474 |
|
24 |
24 |
$216.96 |
| 90698 |
|
42 |
42 |
$5.75 |
| 2014F |
|
159 |
158 |
$0.00 |
| 90670 |
|
40 |
40 |
$0.00 |
| 3008F |
|
538 |
536 |
$0.00 |
| 90680 |
|
24 |
24 |
$0.00 |