| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
220 |
208 |
$19K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
213 |
207 |
$12K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
15 |
15 |
$1K |
| 90686 |
|
52 |
52 |
$627.09 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
28 |
28 |
$406.71 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
13 |
12 |
$363.86 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
105 |
105 |
$358.68 |
| 90670 |
|
13 |
13 |
$299.55 |
| 90461 |
|
38 |
38 |
$127.05 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
12 |
12 |
$33.18 |