| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
928 |
800 |
$36K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
620 |
563 |
$36K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
413 |
364 |
$12K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
149 |
145 |
$8K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
583 |
498 |
$8K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
76 |
74 |
$4K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
37 |
36 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
144 |
71 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
84 |
80 |
$994.64 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
13 |
13 |
$592.47 |
| 99173 |
|
144 |
144 |
$226.92 |
| 36416 |
|
32 |
32 |
$70.41 |
| 90686 |
|
40 |
40 |
$10.00 |
| 90670 |
|
54 |
54 |
$0.05 |
| 90710 |
|
12 |
12 |
$0.02 |
| 90680 |
|
15 |
15 |
$0.00 |
| 90698 |
|
15 |
15 |
$0.00 |
| 90685 |
|
14 |
14 |
$0.00 |