| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
645 |
608 |
$25K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
173 |
165 |
$10K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
262 |
260 |
$9K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
13 |
12 |
$720.84 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
37 |
36 |
$706.92 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
12 |
12 |
$645.07 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
17 |
16 |
$176.97 |
| 90670 |
|
13 |
13 |
$0.00 |
| 90686 |
|
74 |
73 |
$0.00 |
| 94760 |
|
14 |
14 |
$0.00 |