| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,066 |
884 |
$38K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
175 |
160 |
$8K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
384 |
352 |
$5K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
182 |
170 |
$4K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
178 |
85 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
14 |
14 |
$700.00 |
| 90461 |
|
13 |
13 |
$235.00 |
| 92551 |
|
12 |
12 |
$133.10 |
| 90686 |
|
13 |
13 |
$62.13 |
| 99173 |
|
15 |
14 |
$0.00 |