| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
264 |
249 |
$15K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
60 |
60 |
$5K |
| 90670 |
|
12 |
12 |
$447.85 |
| 90686 |
|
26 |
26 |
$307.24 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
146 |
143 |
$231.65 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
96 |
95 |
$204.25 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
14 |
13 |
$200.25 |
| 90648 |
|
12 |
12 |
$158.98 |
| 99173 |
|
17 |
17 |
$44.03 |
| 99051 |
|
59 |
59 |
$0.00 |