| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
377 |
364 |
$15K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
188 |
91 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
42 |
42 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
14 |
14 |
$978.76 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
16 |
16 |
$853.65 |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
28 |
27 |
$673.63 |