| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
589 |
510 |
$44K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
114 |
109 |
$5K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
149 |
143 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
13 |
13 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
44 |
40 |
$581.48 |
| 85018 |
|
223 |
221 |
$566.00 |
| 81002 |
|
136 |
134 |
$381.87 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
24 |
14 |
$320.08 |