| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,028 |
4,784 |
$271K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,810 |
2,799 |
$158K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
770 |
734 |
$60K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
84 |
84 |
$6K |
| 90461 |
|
87 |
87 |
$4K |
| 81000 |
|
835 |
829 |
$2K |
| 0071A |
|
34 |
34 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
81 |
77 |
$937.17 |
| 87081 |
|
39 |
37 |
$180.96 |
| 90686 |
|
546 |
545 |
$0.00 |
| 90656 |
|
57 |
57 |
$0.00 |
| 91307 |
|
15 |
15 |
$0.00 |