| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,320 |
1,263 |
$21K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,999 |
1,731 |
$20K |
| 92587 |
|
554 |
547 |
$12K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
368 |
341 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
54 |
54 |
$2K |
| 86580 |
|
294 |
289 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
25 |
25 |
$990.32 |
| 90686 |
|
230 |
215 |
$713.25 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12 |
12 |
$452.78 |
| 90461 |
|
27 |
27 |
$377.35 |
| 99402 |
|
248 |
239 |
$308.32 |
| 97802 |
|
94 |
91 |
$297.38 |
| 99188 |
|
13 |
13 |
$195.00 |
| 99173 |
|
174 |
174 |
$35.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
13 |
12 |
$8.27 |