| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,215 |
1,915 |
$109K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
813 |
802 |
$14K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
119 |
113 |
$8K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
101 |
100 |
$6K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
80 |
80 |
$6K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
573 |
540 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
55 |
55 |
$4K |
| 99051 |
|
554 |
536 |
$2K |
| 90686 |
|
68 |
68 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
110 |
52 |
$909.54 |
| 90461 |
|
28 |
27 |
$400.54 |
| 90688 |
|
12 |
12 |
$169.76 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
16 |
16 |
$132.16 |
| 99173 |
|
45 |
45 |
$96.39 |
| 99000 |
|
227 |
221 |
$0.00 |