| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,384 |
2,068 |
$94K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
3,605 |
1,247 |
$51K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,277 |
1,088 |
$30K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
354 |
337 |
$20K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
338 |
308 |
$16K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
38 |
38 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
222 |
88 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
26 |
26 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
63 |
54 |
$614.11 |
| 96127 |
|
27 |
27 |
$112.91 |
| 90686 |
|
138 |
132 |
$61.68 |
| 90700 |
|
67 |
66 |
$0.00 |
| 90670 |
|
167 |
156 |
$0.00 |
| 99072 |
|
41 |
37 |
$0.00 |
| 90647 |
|
173 |
157 |
$0.00 |