| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,810 |
1,702 |
$119K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
485 |
272 |
$7K |
| 87428 |
|
42 |
42 |
$2K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
14 |
14 |
$1K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
14 |
13 |
$1K |
| 90461 |
|
28 |
27 |
$958.72 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
79 |
76 |
$722.17 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
13 |
12 |
$465.03 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
28 |
14 |
$359.32 |