| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,977 |
1,946 |
$186K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,472 |
2,370 |
$147K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,839 |
1,816 |
$65K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
415 |
413 |
$57K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
294 |
294 |
$22K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
279 |
279 |
$21K |
| 90461 |
|
558 |
552 |
$16K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
201 |
195 |
$14K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
68 |
68 |
$5K |
| 92552 |
|
245 |
245 |
$4K |
| 95816 |
|
25 |
25 |
$973.05 |
| 95885 |
|
13 |
12 |
$535.36 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
14 |
14 |
$123.08 |
| 99172 |
|
486 |
484 |
$13.03 |
| 90713 |
|
12 |
12 |
$0.00 |
| 90734 |
|
13 |
13 |
$0.00 |
| 90700 |
|
14 |
14 |
$0.00 |
| 90715 |
|
12 |
12 |
$0.00 |
| 90656 |
|
27 |
27 |
$0.00 |
| 90716 |
|
12 |
12 |
$0.00 |