| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
697 |
532 |
$47K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
363 |
326 |
$13K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
90 |
80 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
18 |
17 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
50 |
45 |
$462.71 |
| 81003 |
|
161 |
151 |
$335.83 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
30 |
27 |
$232.41 |
| 85018 |
|
39 |
37 |
$81.62 |