| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,039 |
3,606 |
$333K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
591 |
487 |
$63K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
256 |
248 |
$33K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
3,753 |
1,638 |
$13K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
66 |
66 |
$9K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
24 |
24 |
$4K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
13 |
12 |
$1K |
| 90461 |
|
411 |
321 |
$1K |
| 90686 |
|
100 |
96 |
$552.23 |
| 92587 |
|
82 |
75 |
$265.08 |
| 97803 |
|
2,422 |
2,245 |
$112.22 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
61 |
58 |
$111.89 |
| 99173 |
|
68 |
57 |
$72.03 |
| 99000 |
|
74 |
70 |
$0.00 |
| 90713 |
|
16 |
12 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
103 |
50 |
$0.00 |
| 90700 |
|
61 |
60 |
$0.00 |