| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,009 |
798 |
$124K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
543 |
510 |
$18K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
38 |
36 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
14 |
12 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
25 |
21 |
$712.11 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
96 |
21 |
$289.80 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
47 |
19 |
$124.20 |
| 99051 |
|
127 |
121 |
$0.00 |
| 90461 |
|
13 |
12 |
$0.00 |
| 3008F |
|
187 |
104 |
$0.00 |
| 90656 |
|
27 |
27 |
$0.00 |
| 90686 |
|
36 |
21 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
123 |
56 |
$0.00 |