| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,294 |
2,212 |
$153K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
932 |
930 |
$47K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
200 |
200 |
$20K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
124 |
124 |
$11K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
99 |
98 |
$9K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
302 |
295 |
$5K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
71 |
69 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
13 |
13 |
$1K |
| 99173 |
|
128 |
128 |
$100.00 |
| 96161 |
|
12 |
12 |
$50.59 |
| 96160 |
|
49 |
49 |
$28.74 |
| 92551 |
|
55 |
55 |
$25.00 |
| 96127 |
|
24 |
24 |
$11.00 |
| 3008F |
|
1,471 |
1,407 |
$6.75 |
| 90686 |
|
42 |
42 |
$0.00 |