| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,466 |
1,284 |
$105K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
84 |
84 |
$7K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
44 |
44 |
$4K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
507 |
507 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
28 |
28 |
$3K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
65 |
65 |
$3K |
| 81000 |
|
433 |
432 |
$2K |
| 81002 |
|
117 |
116 |
$231.70 |
| 90658 |
|
174 |
174 |
$134.40 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
25 |
24 |
$93.75 |
| 90686 |
|
46 |
46 |
$47.06 |
| 99173 |
|
32 |
32 |
$0.00 |