| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
206 |
196 |
$14K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
89 |
82 |
$9K |
| 90461 |
|
71 |
71 |
$4K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
31 |
31 |
$3K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
28 |
28 |
$3K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
100 |
100 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
26 |
26 |
$717.75 |
| 90686 |
|
37 |
37 |
$0.00 |