| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
893 |
779 |
$51K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
212 |
210 |
$17K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
210 |
210 |
$16K |
| 90670 |
|
221 |
221 |
$4K |
| 99188 |
|
142 |
142 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
35 |
35 |
$3K |
| 90710 |
|
45 |
44 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
120 |
117 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
17 |
17 |
$1K |
| 90723 |
|
86 |
86 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
14 |
13 |
$1K |
| 90700 |
|
89 |
89 |
$1K |
| 90633 |
|
85 |
85 |
$1K |
| 90680 |
|
64 |
64 |
$820.89 |
| 90647 |
|
64 |
64 |
$789.42 |
| 85018 |
|
262 |
258 |
$725.76 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
31 |
30 |
$669.32 |
| 81002 |
|
100 |
99 |
$307.89 |
| 90744 |
|
25 |
25 |
$293.57 |
| 90696 |
|
13 |
13 |
$227.39 |
| 90657 |
|
12 |
12 |
$150.72 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
30 |
12 |
$0.00 |