| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,435 |
1,247 |
$117K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
161 |
138 |
$8K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
62 |
59 |
$4K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
50 |
44 |
$3K |
| 92552 |
|
124 |
122 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
63 |
58 |
$806.17 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
26 |
19 |
$534.10 |
| 99050 |
|
76 |
67 |
$456.90 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
29 |
17 |
$420.10 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
60 |
53 |
$347.90 |
| 99051 |
|
75 |
69 |
$340.00 |
| 99401 |
|
102 |
93 |
$0.00 |
| 99173 |
|
30 |
30 |
$0.00 |
| 97802 |
|
128 |
114 |
$0.00 |
| 99000 |
|
44 |
42 |
$0.00 |