| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,158 |
2,650 |
$128K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
3,706 |
1,668 |
$53K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
636 |
597 |
$32K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
503 |
463 |
$28K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
350 |
333 |
$19K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
147 |
138 |
$8K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
66 |
33 |
$807.90 |
| 90670 |
|
421 |
396 |
$40.30 |
| 90648 |
|
403 |
382 |
$30.30 |
| 90723 |
|
266 |
251 |
$30.19 |
| 90658 |
|
80 |
73 |
$0.03 |
| 90633 |
|
15 |
14 |
$0.02 |
| 90681 |
|
29 |
29 |
$0.02 |
| 90657 |
|
15 |
15 |
$0.00 |