| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
504 |
466 |
$43K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
90 |
90 |
$7K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
95 |
91 |
$7K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
79 |
78 |
$6K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
194 |
94 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
46 |
42 |
$3K |
| 92551 |
|
236 |
233 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
15 |
15 |
$1K |
| 90670 |
|
92 |
90 |
$1K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
305 |
300 |
$700.96 |
| 99173 |
|
240 |
238 |
$606.06 |
| 90651 |
|
17 |
17 |
$541.48 |
| 90461 |
|
178 |
176 |
$441.80 |
| 90710 |
|
17 |
17 |
$391.83 |
| 90633 |
|
28 |
28 |
$358.76 |
| 90734 |
|
12 |
12 |
$250.04 |
| 90696 |
|
17 |
17 |
$229.85 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
18 |
17 |
$218.25 |
| 90648 |
|
17 |
16 |
$184.29 |
| 90686 |
|
12 |
12 |
$132.17 |