| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,007 |
992 |
$37K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
130 |
130 |
$11K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
880 |
878 |
$10K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
92 |
92 |
$7K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
86 |
86 |
$6K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
338 |
337 |
$4K |
| 90686 |
|
354 |
353 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
28 |
28 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
13 |
13 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
42 |
42 |
$715.45 |
| 90633 |
|
33 |
33 |
$607.20 |
| 90734 |
|
13 |
13 |
$239.20 |
| 90698 |
|
38 |
38 |
$0.00 |
| 3008F |
|
556 |
555 |
$0.00 |
| 2014F |
|
188 |
187 |
$0.00 |
| 90670 |
|
26 |
26 |
$0.00 |