| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
267 |
218 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
35 |
33 |
$644.09 |
| 99000 |
|
32 |
31 |
$72.36 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
32 |
30 |
$29.80 |
| 90461 |
|
25 |
24 |
$20.20 |
| 81002 |
|
13 |
13 |
$5.54 |
| 96160 |
|
21 |
14 |
$2.33 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
16 |
16 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
13 |
13 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
15 |
13 |
$0.00 |