| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
295 |
289 |
$37K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
180 |
172 |
$31K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
175 |
105 |
$8K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
12 |
12 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
78 |
78 |
$2K |
| 99051 |
|
14 |
13 |
$420.00 |
| 87081 |
|
27 |
27 |
$330.39 |