| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
321 |
300 |
$25K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
179 |
174 |
$20K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
81 |
81 |
$9K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
55 |
55 |
$7K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
55 |
55 |
$6K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
180 |
180 |
$5K |
| 97802 |
|
166 |
166 |
$5K |
| 90461 |
|
95 |
95 |
$4K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
111 |
108 |
$2K |
| 99188 |
|
32 |
32 |
$570.24 |
| 96127 |
|
70 |
70 |
$540.37 |
| 99177 |
|
32 |
32 |
$103.36 |
| S9451 |
Exercise classes, non-physician provider, per session |
196 |
196 |
$0.00 |
| 94760 |
|
16 |
16 |
$0.00 |
| 90651 |
|
14 |
14 |
$0.00 |
| 90686 |
|
17 |
17 |
$0.00 |
| 90633 |
|
61 |
61 |
$0.00 |