| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,275 |
1,950 |
$80K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
692 |
668 |
$31K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
241 |
185 |
$11K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
79 |
76 |
$5K |
| 90461 |
|
79 |
73 |
$3K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
160 |
67 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12 |
12 |
$946.10 |
| 87428 |
|
13 |
12 |
$462.19 |
| 97802 |
|
32 |
29 |
$181.95 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
13 |
13 |
$168.44 |
| 90670 |
|
12 |
12 |
$0.00 |
| 90694 |
|
73 |
72 |
$0.00 |
| 90677 |
|
12 |
12 |
$0.00 |