| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
743 |
658 |
$29K |
| 99051 |
|
303 |
271 |
$6K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
163 |
111 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
31 |
30 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
13 |
12 |
$768.30 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
59 |
51 |
$615.72 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
26 |
12 |
$312.72 |
| 92551 |
|
13 |
13 |
$63.80 |
| 90656 |
|
13 |
12 |
$0.00 |
| 90686 |
|
17 |
16 |
$0.00 |