| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,647 |
2,168 |
$192K |
| 99215 |
Prolong outpt/office vis |
1,806 |
1,446 |
$191K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
336 |
283 |
$16K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
54 |
54 |
$6K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
27 |
27 |
$3K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
25 |
25 |
$3K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
375 |
369 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
38 |
37 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
43 |
40 |
$686.43 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
219 |
196 |
$588.47 |
| 90651 |
|
17 |
16 |
$496.20 |
| 90461 |
|
14 |
13 |
$400.00 |
| 99173 |
|
279 |
235 |
$134.77 |
| 99050 |
|
28 |
28 |
$0.00 |
| 99072 |
|
18 |
17 |
$0.00 |