| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
207 |
201 |
$17K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
259 |
243 |
$15K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
18 |
18 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
13 |
13 |
$897.71 |
| 90686 |
|
77 |
75 |
$892.70 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
59 |
57 |
$840.09 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
129 |
128 |
$479.22 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
13 |
13 |
$378.40 |
| 92551 |
|
34 |
34 |
$364.45 |
| 90461 |
|
43 |
43 |
$246.60 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
30 |
30 |
$80.85 |
| 96127 |
|
12 |
12 |
$71.39 |
| 99173 |
|
17 |
17 |
$44.03 |