| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
904 |
798 |
$61K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
360 |
354 |
$17K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
105 |
103 |
$12K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
64 |
63 |
$7K |
| 92552 |
|
56 |
56 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
12 |
12 |
$1K |
| 99188 |
|
58 |
58 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
36 |
18 |
$583.92 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
23 |
21 |
$340.20 |
| 99174 |
|
61 |
61 |
$185.75 |
| 90686 |
|
36 |
28 |
$138.02 |
| S9451 |
Exercise classes, non-physician provider, per session |
46 |
46 |
$0.00 |
| 4124F |
|
125 |
109 |
$0.00 |
| 3210F |
|
62 |
56 |
$0.00 |
| 90670 |
|
14 |
14 |
$0.00 |
| S9470 |
Nutritional counseling, dietitian visit |
35 |
35 |
$0.00 |