| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,214 |
1,082 |
$43K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
582 |
580 |
$26K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
339 |
318 |
$8K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
39 |
38 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
39 |
39 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
76 |
39 |
$700.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12 |
12 |
$582.84 |
| 92552 |
|
39 |
39 |
$470.81 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
37 |
36 |
$212.45 |
| 81002 |
|
134 |
132 |
$201.34 |
| 99173 |
|
25 |
25 |
$15.21 |
| 99406 |
|
16 |
16 |
$0.00 |