| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,193 |
2,050 |
$121K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,343 |
1,262 |
$107K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,324 |
1,103 |
$72K |
| 90461 |
|
373 |
352 |
$19K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
168 |
168 |
$12K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
149 |
149 |
$10K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
82 |
82 |
$6K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
70 |
69 |
$5K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
127 |
127 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
56 |
55 |
$649.57 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
24 |
12 |
$284.40 |
| 96127 |
|
63 |
62 |
$201.27 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
44 |
43 |
$200.21 |
| 99173 |
|
778 |
778 |
$0.00 |
| 90734 |
|
12 |
12 |
$0.00 |
| 90670 |
|
12 |
12 |
$0.00 |
| 90656 |
|
24 |
24 |
$0.00 |
| 90686 |
|
225 |
224 |
$0.00 |