| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,627 |
3,952 |
$234K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
871 |
828 |
$16K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
411 |
371 |
$10K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
100 |
100 |
$7K |
| 99173 |
|
693 |
687 |
$6K |
| 92551 |
|
616 |
615 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
24 |
24 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
124 |
61 |
$2K |
| 90686 |
|
246 |
245 |
$1K |
| 96127 |
|
254 |
254 |
$921.26 |
| 81002 |
|
472 |
465 |
$868.41 |
| 99442 |
|
12 |
12 |
$273.07 |
| 90656 |
|
26 |
26 |
$234.73 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
24 |
24 |
$98.32 |
| 85018 |
|
13 |
13 |
$24.16 |
| 36416 |
|
12 |
12 |
$0.00 |