| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
79 |
72 |
$5K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
15 |
15 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
40 |
19 |
$542.40 |
| 97802 |
|
14 |
14 |
$428.54 |
| 90461 |
|
12 |
12 |
$302.60 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
14 |
14 |
$298.48 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
14 |
14 |
$211.82 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
14 |
14 |
$188.15 |