| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
208 |
192 |
$12K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
66 |
64 |
$5K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
33 |
27 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
29 |
26 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
17 |
17 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
66 |
65 |
$39.70 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
255 |
245 |
$10.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
78 |
38 |
$0.00 |
| 90461 |
|
48 |
43 |
$0.00 |
| 90686 |
|
67 |
67 |
$0.00 |