| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
237 |
221 |
$13K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
14 |
14 |
$1K |
| 85018 |
|
90 |
89 |
$252.60 |
| 90686 |
|
20 |
20 |
$251.48 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
65 |
65 |
$193.49 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
12 |
12 |
$172.53 |
| 99173 |
|
60 |
58 |
$147.27 |
| 36416 |
|
103 |
101 |
$104.88 |
| 96127 |
|
12 |
12 |
$59.76 |
| 90461 |
|
13 |
13 |
$51.50 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
14 |
14 |
$16.59 |
| 0001F |
|
200 |
189 |
$0.00 |