| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
164 |
157 |
$1K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
75 |
74 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
14 |
14 |
$646.63 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
16 |
16 |
$511.23 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
48 |
47 |
$498.29 |
| 90461 |
|
18 |
18 |
$220.50 |
| 92551 |
|
33 |
33 |
$171.85 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
27 |
27 |
$99.06 |
| 99173 |
|
25 |
25 |
$48.00 |