| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
351 |
330 |
$21K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
182 |
170 |
$16K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
14 |
14 |
$1K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
44 |
44 |
$929.29 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
25 |
25 |
$879.09 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
34 |
17 |
$454.40 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
12 |
12 |
$155.98 |
| 90686 |
|
21 |
21 |
$0.00 |