| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,052 |
4,255 |
$859K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
990 |
951 |
$93K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
241 |
235 |
$45K |
| 90686 |
|
232 |
226 |
$37K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
249 |
230 |
$36K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
112 |
108 |
$21K |
| W0037 |
|
2,205 |
2,205 |
$20K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
112 |
104 |
$20K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
103 |
41 |
$18K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
89 |
79 |
$12K |
| 81003 |
|
62 |
42 |
$10K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
321 |
316 |
$6K |
| 36415 |
Collection of venous blood by venipuncture |
111 |
93 |
$5K |
| 87807 |
|
20 |
13 |
$3K |
| 90651 |
|
51 |
49 |
$3K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12 |
12 |
$2K |
| G0467 |
Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit |
16 |
13 |
$499.65 |
| 90661 |
|
39 |
39 |
$0.00 |
| 90734 |
|
42 |
42 |
$0.00 |
| 90715 |
|
14 |
13 |
$0.00 |
| 99307 |
|
12 |
12 |
$0.00 |