| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
191 |
184 |
$20K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
173 |
164 |
$12K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
46 |
46 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
33 |
33 |
$4K |
| 97802 |
|
144 |
144 |
$4K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
164 |
164 |
$2K |
| 90461 |
|
62 |
62 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12 |
12 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
73 |
72 |
$940.97 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
18 |
18 |
$388.98 |
| 90686 |
|
77 |
77 |
$0.00 |
| 90651 |
|
17 |
17 |
$0.00 |