| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
113 |
82 |
$6K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
468 |
160 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
174 |
122 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
47 |
28 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
55 |
44 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
28 |
15 |
$887.96 |
| 92551 |
|
160 |
104 |
$610.73 |
| 90461 |
|
104 |
61 |
$148.96 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
22 |
15 |
$138.90 |
| 3008F |
|
63 |
63 |
$0.00 |
| 90688 |
|
14 |
14 |
$0.00 |
| 99051 |
|
15 |
15 |
$0.00 |
| 99173 |
|
99 |
81 |
$0.00 |