| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
259 |
240 |
$15K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
54 |
54 |
$5K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
51 |
51 |
$4K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
28 |
28 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
20 |
20 |
$2K |
| 90461 |
|
84 |
83 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
115 |
114 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
12 |
12 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
15 |
14 |
$204.18 |
| 90633 |
|
12 |
12 |
$0.00 |
| 90670 |
|
24 |
24 |
$0.00 |
| 90647 |
|
15 |
15 |
$0.00 |
| 90651 |
|
13 |
13 |
$0.00 |