| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
222 |
207 |
$12K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
13 |
13 |
$1K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
125 |
53 |
$458.57 |
| 90686 |
|
31 |
31 |
$418.80 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
14 |
14 |
$186.39 |
| 92551 |
|
15 |
15 |
$158.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
15 |
15 |
$82.95 |
| 99173 |
|
12 |
12 |
$28.13 |