| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
309 |
275 |
$18K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
29 |
27 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
27 |
26 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
25 |
25 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
18 |
17 |
$1K |
| 90670 |
|
39 |
39 |
$732.22 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
27 |
26 |
$354.78 |
| 90461 |
|
112 |
112 |
$340.10 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
150 |
150 |
$337.78 |
| 90648 |
|
25 |
25 |
$236.54 |
| 90723 |
|
12 |
12 |
$135.30 |