| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,822 |
2,363 |
$180K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,247 |
1,188 |
$18K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
17 |
17 |
$1K |
| 92587 |
|
47 |
47 |
$1K |
| 92551 |
|
59 |
57 |
$426.52 |
| 99177 |
|
18 |
18 |
$310.64 |
| 90461 |
|
12 |
12 |
$271.24 |
| 36415 |
Collection of venous blood by venipuncture |
505 |
496 |
$204.69 |
| 90658 |
|
30 |
29 |
$146.88 |
| 81000 |
|
41 |
41 |
$106.89 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
21 |
19 |
$103.90 |
| 99173 |
|
52 |
50 |
$5.70 |
| 99000 |
|
440 |
432 |
$5.09 |
| 90713 |
|
17 |
15 |
$0.00 |