| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
68 |
67 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
17 |
17 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12 |
12 |
$830.88 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
21 |
21 |
$686.34 |
| 94760 |
|
48 |
45 |
$56.36 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
13 |
13 |
$49.08 |
| 99173 |
|
12 |
12 |
$0.00 |
| 99000 |
|
16 |
16 |
$0.00 |