| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,793 |
2,117 |
$112K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,106 |
1,022 |
$32K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
226 |
192 |
$15K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
160 |
144 |
$11K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
26 |
25 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
124 |
57 |
$2K |
| 90461 |
|
31 |
29 |
$727.40 |
| 90672 |
|
110 |
105 |
$252.08 |
| 90723 |
|
42 |
42 |
$31.20 |
| 90670 |
|
72 |
70 |
$15.75 |
| 90687 |
|
12 |
12 |
$15.75 |
| 90681 |
|
12 |
12 |
$0.00 |
| 90647 |
|
27 |
26 |
$0.00 |