| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,274 |
2,073 |
$152K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,343 |
806 |
$18K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
140 |
140 |
$14K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
145 |
139 |
$14K |
| 90461 |
|
133 |
79 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
27 |
24 |
$3K |
| 87428 |
|
28 |
28 |
$2K |
| 99050 |
|
40 |
40 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
109 |
104 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
61 |
61 |
$630.20 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
12 |
12 |
$402.23 |
| 90686 |
|
75 |
75 |
$36.50 |
| 96127 |
|
12 |
12 |
$35.88 |
| 96160 |
|
12 |
12 |
$30.72 |