| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
539 |
516 |
$34K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
207 |
206 |
$24K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
13 |
13 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
114 |
57 |
$1K |
| 99051 |
|
170 |
170 |
$557.38 |
| 90686 |
|
12 |
12 |
$444.90 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
76 |
76 |
$179.60 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
15 |
15 |
$162.28 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
33 |
33 |
$70.04 |