| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,934 |
1,748 |
$70K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
949 |
859 |
$51K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,031 |
981 |
$7K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
79 |
79 |
$7K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
79 |
76 |
$6K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
54 |
53 |
$5K |
| 92551 |
|
953 |
929 |
$2K |
| 99173 |
|
973 |
951 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
15 |
15 |
$1K |
| 90688 |
|
312 |
301 |
$1K |
| 96127 |
|
356 |
324 |
$752.03 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
30 |
15 |
$349.58 |
| 90461 |
|
24 |
24 |
$150.00 |
| 99499 |
|
58 |
48 |
$75.00 |
| 96161 |
|
13 |
13 |
$21.58 |
| 96160 |
|
136 |
132 |
$0.03 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
53 |
53 |
$0.00 |
| 90698 |
|
13 |
12 |
$0.00 |
| 99188 |
|
66 |
66 |
$0.00 |