| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
6,904 |
4,309 |
$408K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
286 |
169 |
$16K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
119 |
116 |
$13K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
76 |
74 |
$8K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
590 |
276 |
$609.76 |
| 90686 |
|
144 |
50 |
$431.54 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
320 |
185 |
$418.18 |
| 97802 |
|
52 |
49 |
$16.65 |
| 91300 |
|
17 |
15 |
$0.00 |