| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
707 |
648 |
$50K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
110 |
102 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
13 |
13 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
58 |
29 |
$747.66 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
48 |
47 |
$488.10 |
| 96127 |
|
13 |
13 |
$42.23 |
| 90686 |
|
16 |
16 |
$8.00 |