| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,062 |
891 |
$87K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
153 |
135 |
$8K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
80 |
73 |
$6K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
368 |
350 |
$5K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
61 |
58 |
$5K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
53 |
49 |
$4K |
| 92552 |
|
100 |
97 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
15 |
15 |
$1K |
| 92015 |
Determination of refractive state |
87 |
84 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
65 |
61 |
$913.89 |
| 90656 |
|
37 |
37 |
$683.00 |
| 90648 |
|
39 |
39 |
$442.75 |
| 90670 |
|
27 |
27 |
$304.15 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
630 |
261 |
$294.38 |
| 81003 |
|
86 |
81 |
$217.69 |
| 90657 |
|
15 |
15 |
$216.48 |
| 81002 |
|
39 |
39 |
$119.94 |
| 90461 |
|
108 |
92 |
$46.20 |