| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
372 |
325 |
$31K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
184 |
159 |
$10K |
| 90686 |
|
248 |
225 |
$4K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
375 |
334 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
24 |
12 |
$142.40 |
| 96127 |
|
13 |
12 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
30 |
25 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
30 |
27 |
$0.00 |
| 96160 |
|
15 |
13 |
$0.00 |