| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,765 |
2,804 |
$146K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,924 |
1,626 |
$71K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
955 |
783 |
$50K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
906 |
725 |
$49K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
930 |
732 |
$46K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
306 |
301 |
$24K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
184 |
178 |
$17K |
| 90461 |
|
679 |
633 |
$17K |
| 90670 |
|
360 |
346 |
$5K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
604 |
517 |
$2K |
| 90698 |
|
221 |
218 |
$1K |
| 90686 |
|
241 |
230 |
$319.55 |
| 90651 |
|
12 |
12 |
$177.52 |
| 90680 |
|
209 |
205 |
$100.00 |
| 90633 |
|
146 |
137 |
$85.49 |
| 90734 |
|
14 |
12 |
$80.88 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
12 |
12 |
$68.52 |
| 90619 |
|
13 |
13 |
$40.00 |
| 90677 |
|
27 |
26 |
$0.00 |
| 90744 |
|
162 |
152 |
$0.00 |