| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
236 |
215 |
$13K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
79 |
73 |
$7K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
20 |
20 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
15 |
15 |
$408.30 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
26 |
23 |
$353.60 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
16 |
16 |
$271.36 |