| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,683 |
6,105 |
$208K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
2,165 |
2,076 |
$20K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
218 |
210 |
$9K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
112 |
112 |
$7K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
214 |
205 |
$5K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
92 |
92 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
29 |
29 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
58 |
58 |
$2K |
| 90677 |
|
55 |
55 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
68 |
32 |
$764.28 |
| 90697 |
|
40 |
40 |
$645.00 |
| 99381 |
|
15 |
12 |
$393.93 |
| 90656 |
|
47 |
47 |
$312.06 |
| 90633 |
|
29 |
29 |
$189.35 |
| 90680 |
|
25 |
25 |
$98.84 |
| 90686 |
|
19 |
19 |
$89.40 |
| 3078F |
|
870 |
833 |
$0.00 |
| 3079F |
|
137 |
126 |
$0.00 |
| 3074F |
|
994 |
947 |
$0.00 |