| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
194 |
178 |
$15K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
69 |
66 |
$8K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
53 |
53 |
$6K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
30 |
30 |
$4K |
| 97802 |
|
88 |
88 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
88 |
88 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
12 |
12 |
$1K |
| 90461 |
|
15 |
15 |
$749.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
30 |
29 |
$411.22 |
| 96127 |
|
29 |
29 |
$226.78 |
| S9451 |
Exercise classes, non-physician provider, per session |
99 |
99 |
$0.00 |
| 90633 |
|
42 |
42 |
$0.00 |