| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,365 |
1,149 |
$77K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
763 |
670 |
$61K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
137 |
130 |
$11K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
188 |
158 |
$6K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
438 |
390 |
$5K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
408 |
182 |
$5K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
62 |
55 |
$5K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
41 |
39 |
$3K |
| 87276 |
|
176 |
154 |
$2K |
| 87275 |
|
175 |
154 |
$2K |
| 87807 |
|
64 |
57 |
$688.29 |
| 92551 |
|
67 |
66 |
$590.79 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
21 |
21 |
$449.60 |
| 86317 |
|
22 |
20 |
$345.15 |
| 99173 |
|
66 |
64 |
$141.90 |
| 90473 |
|
12 |
12 |
$120.00 |
| 90698 |
|
17 |
17 |
$0.00 |
| 90680 |
|
12 |
12 |
$0.00 |
| 90670 |
|
17 |
17 |
$0.00 |