| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,540 |
3,759 |
$299K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,486 |
4,957 |
$288K |
| 90686 |
|
524 |
384 |
$8K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
32 |
30 |
$3K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
164 |
146 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
130 |
117 |
$2K |
| 90656 |
|
54 |
36 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
14 |
14 |
$1K |
| 82962 |
|
230 |
208 |
$392.13 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
41 |
36 |
$248.86 |
| 85018 |
|
72 |
55 |
$162.22 |
| 81003 |
|
39 |
30 |
$82.72 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
24 |
24 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
18 |
13 |
$0.00 |