| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,535 |
1,403 |
$52K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
816 |
717 |
$26K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
97 |
89 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
26 |
26 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
242 |
109 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$970.79 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
49 |
40 |
$527.82 |
| 90461 |
|
15 |
13 |
$102.15 |