| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,893 |
4,235 |
$351K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,986 |
1,915 |
$73K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
296 |
286 |
$31K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,366 |
631 |
$15K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
132 |
123 |
$13K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
87 |
87 |
$10K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
751 |
720 |
$8K |
| 92551 |
|
747 |
724 |
$5K |
| 36416 |
|
785 |
758 |
$3K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
27 |
24 |
$2K |
| 99173 |
|
264 |
254 |
$2K |
| 94760 |
|
418 |
395 |
$682.26 |
| 99050 |
|
14 |
14 |
$181.58 |
| 81002 |
|
212 |
204 |
$46.36 |
| 90461 |
|
389 |
354 |
$20.00 |
| 85018 |
|
651 |
635 |
$4.52 |
| 90686 |
|
645 |
637 |
$0.00 |
| 90685 |
|
31 |
30 |
$0.00 |
| 90670 |
|
25 |
25 |
$0.00 |