| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
178 |
173 |
$10K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
98 |
93 |
$8K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
61 |
61 |
$5K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
38 |
38 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
28 |
28 |
$2K |
| 90461 |
|
101 |
101 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
135 |
135 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
42 |
41 |
$433.02 |
| 81000 |
|
116 |
114 |
$293.67 |
| 85018 |
|
154 |
154 |
$250.92 |
| 96160 |
|
16 |
16 |
$104.16 |
| 92551 |
|
119 |
119 |
$0.00 |
| 90698 |
|
13 |
13 |
$0.00 |
| 94760 |
|
12 |
12 |
$0.00 |
| 90651 |
|
28 |
28 |
$0.00 |
| 90633 |
|
12 |
12 |
$0.00 |
| 90700 |
|
12 |
12 |
$0.00 |
| 90734 |
|
17 |
17 |
$0.00 |
| 90670 |
|
15 |
15 |
$0.00 |
| 90715 |
|
14 |
14 |
$0.00 |