| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,595 |
3,091 |
$176K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
317 |
317 |
$23K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
177 |
177 |
$14K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
190 |
189 |
$13K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
883 |
880 |
$12K |
| 92567 |
|
247 |
242 |
$2K |
| 99442 |
|
18 |
17 |
$782.70 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
43 |
42 |
$46.44 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
12 |
12 |
$45.00 |
| 90686 |
|
180 |
180 |
$30.03 |
| 90685 |
|
29 |
28 |
$0.00 |
| 90700 |
|
54 |
54 |
$0.00 |
| 90713 |
|
15 |
15 |
$0.00 |