| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,650 |
1,540 |
$63K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
649 |
531 |
$19K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
204 |
191 |
$11K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
26 |
26 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
17 |
15 |
$901.05 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
12 |
12 |
$709.20 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
20 |
19 |
$158.30 |
| 90686 |
|
93 |
93 |
$23.47 |
| 94760 |
|
12 |
12 |
$0.00 |