| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
556 |
488 |
$47K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
86 |
86 |
$11K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
51 |
51 |
$6K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
48 |
48 |
$6K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
41 |
39 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
31 |
31 |
$4K |
| 90461 |
|
114 |
114 |
$3K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
173 |
172 |
$3K |
| 81000 |
|
175 |
172 |
$659.75 |
| 85018 |
|
176 |
176 |
$423.12 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
13 |
13 |
$201.11 |
| 83655 |
|
12 |
12 |
$151.08 |
| 96160 |
|
13 |
13 |
$127.01 |
| 92551 |
|
138 |
138 |
$18.26 |
| 94760 |
|
12 |
12 |
$0.00 |
| 90698 |
|
12 |
12 |
$0.00 |
| 90700 |
|
14 |
14 |
$0.00 |
| 90670 |
|
27 |
27 |
$0.00 |