| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,851 |
2,431 |
$183K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
757 |
704 |
$74K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
735 |
728 |
$14K |
| 92552 |
|
300 |
300 |
$10K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
911 |
840 |
$7K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
77 |
77 |
$6K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
63 |
63 |
$5K |
| 92557 |
|
95 |
94 |
$2K |
| 92081 |
|
32 |
32 |
$1K |
| 99173 |
|
344 |
343 |
$786.03 |
| 81002 |
|
343 |
339 |
$638.86 |
| 92568 |
|
32 |
32 |
$293.76 |
| 92567 |
|
15 |
15 |
$181.68 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
24 |
12 |
$141.90 |
| 90461 |
|
39 |
39 |
$20.33 |
| 90686 |
|
59 |
59 |
$0.00 |
| 90658 |
|
23 |
23 |
$0.00 |