| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
201 |
178 |
$11K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
256 |
120 |
$4K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
41 |
41 |
$3K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
34 |
34 |
$3K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
36 |
33 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
29 |
29 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
159 |
142 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
48 |
48 |
$2K |
| 90670 |
|
33 |
32 |
$957.28 |
| 90651 |
|
25 |
25 |
$764.10 |
| 92551 |
|
79 |
79 |
$752.58 |
| 90680 |
|
25 |
24 |
$571.25 |
| 90688 |
|
49 |
49 |
$500.82 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
28 |
27 |
$404.82 |
| 90698 |
|
14 |
13 |
$312.00 |
| 81002 |
|
107 |
100 |
$298.96 |
| 90647 |
|
19 |
19 |
$239.46 |
| 90723 |
|
13 |
13 |
$204.73 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
32 |
14 |
$200.00 |
| 99173 |
|
78 |
78 |
$180.31 |
| 85018 |
|
56 |
56 |
$145.22 |
| 90633 |
|
12 |
12 |
$132.00 |