| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,271 |
1,129 |
$114K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
144 |
134 |
$10K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
53 |
53 |
$8K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
43 |
43 |
$6K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
205 |
202 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
219 |
206 |
$1K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
96 |
92 |
$1K |
| 90461 |
|
12 |
12 |
$205.62 |
| 90686 |
|
108 |
103 |
$19.03 |
| 99173 |
|
166 |
164 |
$0.00 |