| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,366 |
2,173 |
$121K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
179 |
179 |
$16K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
276 |
276 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
27 |
27 |
$2K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
114 |
49 |
$951.52 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
58 |
29 |
$335.40 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
14 |
14 |
$90.30 |
| 90688 |
|
51 |
51 |
$2.00 |
| 90734 |
|
25 |
25 |
$1.00 |
| 90715 |
|
12 |
12 |
$0.00 |