| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
258 |
248 |
$14K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
14 |
13 |
$1K |
| 90686 |
|
57 |
57 |
$698.50 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
42 |
42 |
$597.99 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
162 |
62 |
$430.80 |
| 92551 |
|
16 |
16 |
$146.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
26 |
26 |
$115.77 |
| 90461 |
|
17 |
14 |
$85.20 |