| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
190 |
179 |
$21K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
139 |
130 |
$10K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
35 |
35 |
$4K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
85 |
84 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
17 |
17 |
$2K |
| 97802 |
|
53 |
53 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12 |
12 |
$1K |
| 90461 |
|
13 |
12 |
$582.56 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
26 |
13 |
$344.16 |
| 96127 |
|
34 |
34 |
$265.88 |
| S9451 |
Exercise classes, non-physician provider, per session |
96 |
95 |
$0.00 |
| 90633 |
|
26 |
26 |
$0.00 |