| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
195 |
180 |
$5K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
75 |
67 |
$3K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
103 |
99 |
$2K |
| 90688 |
|
57 |
56 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$707.22 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
50 |
49 |
$620.07 |
| 90686 |
|
19 |
19 |
$370.44 |
| 96127 |
|
16 |
16 |
$167.58 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
13 |
13 |
$114.26 |