| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
11,175 |
8,828 |
$444K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
160 |
132 |
$5K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
240 |
111 |
$3K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
24 |
24 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
15 |
12 |
$808.56 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
44 |
42 |
$665.78 |