| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,405 |
3,166 |
$279K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,989 |
1,845 |
$44K |
| 92552 |
|
2,000 |
1,693 |
$39K |
| 92568 |
|
2,525 |
2,049 |
$25K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
2,412 |
2,002 |
$15K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
941 |
477 |
$11K |
| 94060 |
|
110 |
110 |
$4K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
32 |
32 |
$3K |
| 94642 |
|
133 |
103 |
$2K |
| 92567 |
|
2,487 |
2,015 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
13 |
13 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
12 |
12 |
$900.98 |
| 81000 |
|
236 |
233 |
$631.69 |
| 99172 |
|
258 |
250 |
$162.15 |
| 90656 |
|
51 |
50 |
$39.56 |
| 92550 |
|
374 |
294 |
$0.00 |
| 90633 |
|
15 |
15 |
$0.00 |
| 90686 |
|
137 |
135 |
$0.00 |