| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,848 |
1,610 |
$121K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
166 |
158 |
$17K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
509 |
426 |
$9K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
121 |
60 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
271 |
254 |
$1K |
| 87070 |
|
178 |
171 |
$1K |