| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,403 |
5,713 |
$371K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,112 |
2,036 |
$161K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
107 |
106 |
$9K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
306 |
304 |
$7K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
78 |
78 |
$7K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
43 |
43 |
$3K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
13 |
13 |
$985.88 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
12 |
12 |
$976.08 |
| 86328 |
|
17 |
17 |
$562.35 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
42 |
41 |
$511.53 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
13 |
13 |
$180.02 |
| 99406 |
|
14 |
14 |
$108.16 |
| G0008 |
Administration of influenza virus vaccine |
15 |
15 |
$84.00 |
| 36415 |
Collection of venous blood by venipuncture |
15 |
13 |
$37.80 |
| 1220F |
|
5,488 |
5,053 |
$2.35 |
| 3008F |
|
6,430 |
5,912 |
$0.35 |
| 3016F |
|
172 |
161 |
$0.00 |
| G0270 |
Medical nutrition therapy; reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition or treatment regimen (including additional hours needed for renal disease), individual, face to face with the patient, each 15 minutes |
12 |
12 |
$0.00 |