| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
220 |
211 |
$21K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
164 |
151 |
$10K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
58 |
58 |
$6K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
49 |
49 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
30 |
30 |
$3K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
30 |
29 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
128 |
59 |
$2K |
| 90461 |
|
58 |
58 |
$1K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
84 |
84 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
16 |
16 |
$218.72 |
| 99051 |
|
19 |
19 |
$216.00 |
| 81002 |
|
64 |
59 |
$179.95 |
| 96127 |
|
17 |
17 |
$120.87 |
| 99174 |
|
13 |
13 |
$70.85 |
| 90633 |
|
13 |
13 |
$0.00 |
| 90648 |
|
12 |
12 |
$0.00 |