| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
138 |
131 |
$61.51 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
49 |
48 |
$40.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
30 |
30 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
33 |
33 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
115 |
48 |
$0.00 |
| 1160F |
|
178 |
172 |
$0.00 |
| 90707 |
|
12 |
12 |
$0.00 |
| 90648 |
|
15 |
15 |
$0.00 |
| 99173 |
|
15 |
15 |
$0.00 |
| 90670 |
|
20 |
20 |
$0.00 |
| 1159F |
|
178 |
172 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
37 |
37 |
$0.00 |
| 3078F |
|
114 |
109 |
$0.00 |
| T1015 |
Clinic visit/encounter, all-inclusive |
355 |
316 |
$0.00 |
| 90633 |
|
16 |
16 |
$0.00 |
| 81003 |
|
28 |
24 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
92 |
46 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
33 |
33 |
$0.00 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
50 |
50 |
$0.00 |
| 1126F |
|
129 |
124 |
$0.00 |
| 2001F |
|
172 |
166 |
$0.00 |
| 3075F |
|
12 |
12 |
$0.00 |
| 90686 |
|
60 |
60 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
92 |
92 |
$0.00 |
| 3008F |
|
169 |
163 |
$0.00 |
| 1036F |
|
162 |
156 |
$0.00 |
| 3074F |
|
124 |
119 |
$0.00 |
| 90680 |
|
14 |
14 |
$0.00 |
| 92551 |
|
37 |
37 |
$0.00 |
| 3079F |
|
17 |
17 |
$0.00 |
| 90716 |
|
12 |
12 |
$0.00 |