| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,340 |
2,155 |
$150K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,120 |
1,101 |
$13K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
142 |
142 |
$13K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
331 |
310 |
$13K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
102 |
102 |
$10K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
62 |
62 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
28 |
28 |
$3K |
| 99441 |
|
28 |
27 |
$618.85 |
| 90686 |
|
304 |
304 |
$496.97 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
27 |
14 |
$406.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
15 |
15 |
$87.15 |
| 90670 |
|
75 |
75 |
$0.00 |
| 90685 |
|
12 |
12 |
$0.00 |
| 90710 |
|
13 |
13 |
$0.00 |
| 90734 |
|
15 |
15 |
$0.00 |
| 90698 |
|
63 |
63 |
$0.00 |