| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
3,603 |
3,491 |
$75K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,317 |
2,067 |
$44K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
462 |
454 |
$23K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,515 |
1,434 |
$21K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
449 |
443 |
$20K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
287 |
284 |
$15K |
| 99173 |
|
1,941 |
1,916 |
$3K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
41 |
39 |
$3K |
| 90674 |
|
122 |
118 |
$2K |
| 90685 |
|
183 |
183 |
$2K |
| 90619 |
|
12 |
12 |
$2K |
| 90686 |
|
290 |
284 |
$864.18 |
| 90656 |
|
41 |
41 |
$836.42 |
| 90658 |
|
16 |
16 |
$238.22 |
| 96127 |
|
31 |
30 |
$23.27 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
13 |
13 |
$0.00 |