| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
323 |
312 |
$18K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
78 |
78 |
$6K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
50 |
49 |
$4K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
49 |
48 |
$4K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
36 |
36 |
$3K |
| 90686 |
|
142 |
139 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
31 |
31 |
$444.84 |
| 90648 |
|
28 |
28 |
$308.00 |
| 90670 |
|
14 |
14 |
$154.00 |
| 90723 |
|
13 |
13 |
$143.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
123 |
119 |
$138.50 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
56 |
56 |
$132.54 |
| 90680 |
|
13 |
12 |
$132.00 |
| 99173 |
|
41 |
41 |
$104.27 |
| 90461 |
|
17 |
17 |
$42.60 |
| 99051 |
|
103 |
103 |
$25.20 |
| 87081 |
|
14 |
14 |
$22.98 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
12 |
12 |
$0.00 |