| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,138 |
3,477 |
$149K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
257 |
237 |
$12K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
111 |
100 |
$7K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
126 |
110 |
$7K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
500 |
488 |
$6K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
94 |
83 |
$4K |
| 90834 |
Psychotherapy, 45 minutes with patient |
480 |
149 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,030 |
765 |
$3K |
| T1015 |
Clinic visit/encounter, all-inclusive |
1,706 |
944 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
31 |
30 |
$2K |
| 0012A |
|
131 |
87 |
$2K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
591 |
455 |
$2K |
| 0011A |
|
108 |
85 |
$2K |
| 92551 |
|
279 |
252 |
$2K |
| 0002A |
|
81 |
59 |
$2K |
| 0001A |
|
98 |
72 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
44 |
44 |
$564.59 |
| 99173 |
|
266 |
244 |
$445.65 |
| 90474 |
|
62 |
47 |
$109.56 |
| H2020 |
Therapeutic behavioral services, per diem |
173 |
36 |
$48.84 |
| 85018 |
|
20 |
15 |
$35.40 |
| 36415 |
Collection of venous blood by venipuncture |
21 |
14 |
$12.04 |
| 96127 |
|
18 |
17 |
$5.00 |
| 91301 |
|
177 |
160 |
$0.00 |
| 3008F |
|
107 |
67 |
$0.00 |
| 90634 |
|
14 |
12 |
$0.00 |
| 3074F |
|
28 |
18 |
$0.00 |
| 90658 |
|
37 |
14 |
$0.00 |
| 91300 |
|
147 |
126 |
$0.00 |
| 90670 |
|
13 |
13 |
$0.00 |
| 3078F |
|
25 |
17 |
$0.00 |