| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
448 |
429 |
$34K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
250 |
238 |
$26K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
14 |
14 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
65 |
63 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
20 |
20 |
$662.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
29 |
27 |
$466.59 |
| 96127 |
|
27 |
27 |
$146.38 |
| 87070 |
|
13 |
13 |
$124.41 |
| 92551 |
|
18 |
18 |
$26.18 |