| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
258 |
231 |
$18K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
464 |
373 |
$14K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,196 |
427 |
$14K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
251 |
217 |
$12K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
80 |
76 |
$6K |
| 99381 |
|
27 |
25 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
41 |
19 |
$430.35 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
44 |
36 |
$418.71 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
17 |
12 |
$300.48 |
| 90461 |
|
277 |
204 |
$61.65 |
| 96160 |
|
552 |
454 |
$47.25 |
| 96127 |
|
283 |
234 |
$0.00 |
| 90680 |
|
100 |
93 |
$0.00 |
| 90698 |
|
60 |
54 |
$0.00 |
| 90697 |
|
37 |
36 |
$0.00 |
| 90686 |
|
61 |
55 |
$0.00 |
| 36416 |
|
12 |
12 |
$0.00 |
| G2211 |
Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) |
97 |
63 |
$0.00 |
| 90670 |
|
150 |
139 |
$0.00 |
| 90633 |
|
12 |
12 |
$0.00 |