| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,086 |
1,541 |
$97K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,389 |
1,017 |
$43K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
242 |
171 |
$18K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
161 |
119 |
$12K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
103 |
79 |
$9K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
325 |
276 |
$2K |
| 92587 |
|
771 |
525 |
$220.32 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
172 |
169 |
$39.72 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
18 |
18 |
$9.92 |
| 94760 |
|
94 |
87 |
$0.00 |
| 99174 |
|
737 |
519 |
$0.00 |
| 90461 |
|
189 |
146 |
$0.00 |
| 90734 |
|
13 |
13 |
$0.00 |