| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,763 |
1,595 |
$103K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
798 |
796 |
$17K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
107 |
107 |
$10K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
248 |
248 |
$9K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
57 |
57 |
$6K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
39 |
39 |
$4K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
34 |
34 |
$3K |
| 81002 |
|
450 |
450 |
$2K |
| 90686 |
|
198 |
198 |
$1K |
| 90756 |
|
24 |
24 |
$680.52 |
| 90672 |
|
13 |
13 |
$319.18 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
15 |
15 |
$227.50 |
| 85018 |
|
28 |
28 |
$76.51 |
| 90685 |
|
13 |
13 |
$0.13 |