| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
902 |
845 |
$46K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
260 |
234 |
$17K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
13 |
13 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
48 |
24 |
$614.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
14 |
14 |
$194.04 |
| 36415 |
Collection of venous blood by venipuncture |
101 |
90 |
$99.79 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
64 |
47 |
$47.60 |
| 90461 |
|
25 |
15 |
$20.40 |