| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
234 |
212 |
$14K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
140 |
133 |
$12K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
63 |
63 |
$5K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
49 |
49 |
$4K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
34 |
34 |
$3K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
85 |
84 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
109 |
107 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
27 |
26 |
$666.89 |
| 96127 |
|
104 |
104 |
$456.56 |
| 99188 |
|
13 |
13 |
$134.29 |
| 96160 |
|
90 |
90 |
$0.00 |