| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
193 |
186 |
$14K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
98 |
93 |
$10K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
33 |
33 |
$3K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
30 |
30 |
$3K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
114 |
114 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$1K |
| 90461 |
|
41 |
41 |
$945.75 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
15 |
15 |
$193.35 |
| 85018 |
|
15 |
15 |
$30.75 |
| 36415 |
Collection of venous blood by venipuncture |
12 |
12 |
$25.56 |
| 90686 |
|
35 |
34 |
$0.00 |