| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
291 |
280 |
$16K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
60 |
58 |
$5K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
29 |
29 |
$2K |
| 90686 |
|
63 |
57 |
$697.60 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
31 |
31 |
$440.70 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
82 |
76 |
$187.36 |
| 99173 |
|
51 |
51 |
$108.61 |
| 36416 |
|
17 |
14 |
$12.10 |
| 99051 |
|
15 |
15 |
$0.00 |