| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
89 |
86 |
$5K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
44 |
40 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
13 |
12 |
$831.72 |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
15 |
14 |
$239.82 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
17 |
16 |
$210.00 |
| 36416 |
|
21 |
20 |
$51.09 |
| 85018 |
|
18 |
18 |
$22.93 |
| 90686 |
|
13 |
12 |
$0.00 |