| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
120 |
113 |
$10K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
140 |
135 |
$8K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
33 |
33 |
$3K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
29 |
27 |
$2K |
| 92551 |
|
49 |
49 |
$501.96 |
| 90688 |
|
29 |
27 |
$286.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
19 |
19 |
$261.90 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
18 |
18 |
$247.35 |
| 99173 |
|
49 |
49 |
$124.32 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
160 |
158 |
$82.95 |
| 90461 |
|
58 |
58 |
$41.20 |
| 3008F |
|
549 |
503 |
$0.00 |