| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
374 |
342 |
$26K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
98 |
96 |
$10K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
63 |
63 |
$6K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
53 |
53 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
46 |
46 |
$5K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
169 |
168 |
$3K |
| 90461 |
|
52 |
52 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
39 |
38 |
$502.71 |
| 99177 |
|
26 |
26 |
$73.50 |
| 94760 |
|
27 |
26 |
$1.54 |
| 90686 |
|
76 |
76 |
$0.00 |