| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
431 |
393 |
$38K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
167 |
150 |
$20K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
101 |
64 |
$1K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
12 |
12 |
$1K |
| 99050 |
|
23 |
18 |
$868.82 |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
12 |
12 |
$848.34 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
68 |
63 |
$684.28 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
12 |
12 |
$113.10 |