| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,590 |
4,848 |
$419K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
182 |
157 |
$10K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
27 |
25 |
$3K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
180 |
168 |
$3K |
| 96127 |
|
173 |
56 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
15 |
13 |
$955.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
57 |
55 |
$870.20 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
46 |
41 |
$783.72 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
47 |
43 |
$743.90 |
| 81002 |
|
452 |
406 |
$529.01 |
| 90686 |
|
29 |
28 |
$215.64 |
| 99000 |
|
13 |
13 |
$36.60 |
| 3008F |
|
2,392 |
2,067 |
$0.00 |
| 90461 |
|
22 |
21 |
$0.00 |
| 91300 |
|
16 |
12 |
$0.00 |
| 96160 |
|
45 |
41 |
$0.00 |
| 90685 |
|
14 |
12 |
$0.00 |