| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
138 |
135 |
$10K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
88 |
82 |
$9K |
| 90461 |
|
29 |
29 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
14 |
14 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
13 |
13 |
$1K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
77 |
77 |
$1K |
| 99051 |
|
71 |
68 |
$882.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
19 |
19 |
$487.98 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
24 |
23 |
$311.19 |
| 90686 |
|
13 |
13 |
$0.00 |