| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,050 |
929 |
$71K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
130 |
130 |
$15K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
317 |
315 |
$15K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
58 |
58 |
$7K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
13 |
13 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$1K |
| 99188 |
|
46 |
46 |
$1K |
| 92552 |
|
43 |
43 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
70 |
65 |
$808.95 |
| 90686 |
|
12 |
12 |
$87.02 |
| 99174 |
|
42 |
42 |
$78.09 |
| 3210F |
|
180 |
156 |
$72.92 |
| 4124F |
|
194 |
181 |
$0.00 |