| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
423 |
379 |
$28K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
72 |
72 |
$7K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
27 |
27 |
$3K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
117 |
117 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$1K |
| 90461 |
|
60 |
60 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
28 |
27 |
$729.98 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
53 |
53 |
$644.50 |
| 85018 |
|
127 |
126 |
$258.30 |
| 96127 |
|
32 |
32 |
$227.52 |
| 81003 |
|
101 |
100 |
$195.94 |
| 87081 |
|
28 |
28 |
$160.72 |
| 90686 |
|
31 |
31 |
$0.00 |
| 90633 |
|
14 |
14 |
$0.00 |
| 90670 |
|
12 |
12 |
$0.00 |