| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,072 |
1,004 |
$95K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,203 |
1,122 |
$73K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
771 |
764 |
$39K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
191 |
191 |
$16K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
146 |
146 |
$13K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
105 |
105 |
$9K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
65 |
65 |
$6K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
41 |
41 |
$571.90 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
12 |
12 |
$414.13 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
12 |
12 |
$168.24 |
| 96161 |
|
25 |
25 |
$125.00 |
| 36416 |
|
44 |
44 |
$110.85 |
| 36415 |
Collection of venous blood by venipuncture |
30 |
27 |
$76.20 |
| 96160 |
|
30 |
30 |
$0.00 |