| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,722 |
1,253 |
$102K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
555 |
445 |
$18K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
354 |
279 |
$13K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
63 |
46 |
$5K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
44 |
39 |
$4K |
| 96127 |
|
210 |
142 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
89 |
41 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
94 |
80 |
$646.37 |
| 99173 |
|
26 |
12 |
$52.82 |
| 81002 |
|
16 |
12 |
$19.54 |
| 90688 |
|
43 |
34 |
$0.00 |