| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
501 |
448 |
$35K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
58 |
55 |
$6K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
40 |
40 |
$5K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
43 |
43 |
$4K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
42 |
42 |
$4K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
189 |
187 |
$2K |
| 90461 |
|
105 |
105 |
$2K |
| 99070 |
|
312 |
302 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
124 |
122 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
12 |
12 |
$1K |
| 81002 |
|
142 |
138 |
$395.53 |
| 99051 |
|
18 |
17 |
$216.00 |
| 90698 |
|
13 |
13 |
$0.00 |
| 90656 |
|
15 |
15 |
$0.00 |
| 90633 |
|
83 |
82 |
$0.00 |
| 90734 |
|
30 |
30 |
$0.00 |
| 90649 |
|
15 |
15 |
$0.00 |
| 90670 |
|
12 |
12 |
$0.00 |