| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,373 |
1,290 |
$92K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
51 |
51 |
$5K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
657 |
657 |
$5K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
12 |
12 |
$1K |
| 99177 |
|
117 |
117 |
$223.63 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
140 |
140 |
$208.38 |
| 90686 |
|
253 |
253 |
$207.07 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
73 |
73 |
$175.38 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
49 |
49 |
$104.30 |
| 90672 |
|
12 |
12 |
$40.68 |
| 90685 |
|
17 |
17 |
$0.00 |