| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,707 |
1,370 |
$70K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
309 |
242 |
$6K |
| 92552 |
|
245 |
242 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
53 |
52 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
24 |
24 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
85 |
79 |
$711.10 |
| 85018 |
|
274 |
270 |
$573.38 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
13 |
13 |
$567.03 |
| 97802 |
|
106 |
101 |
$554.52 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
42 |
20 |
$392.00 |
| 87070 |
|
53 |
50 |
$252.36 |
| 99177 |
|
46 |
45 |
$94.13 |
| 87184 |
|
26 |
25 |
$86.34 |
| 90686 |
|
31 |
29 |
$19.03 |
| 36416 |
|
122 |
118 |
$0.00 |
| 99072 |
|
14 |
13 |
$0.00 |