| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,415 |
1,890 |
$176K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
408 |
356 |
$30K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
361 |
316 |
$29K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
497 |
416 |
$22K |
| 96127 |
|
654 |
606 |
$13K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
129 |
117 |
$10K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
40 |
36 |
$3K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
148 |
67 |
$3K |
| 90670 |
|
17 |
13 |
$1K |
| 90686 |
|
114 |
97 |
$767.66 |
| 90619 |
|
45 |
45 |
$718.53 |
| 90651 |
|
29 |
29 |
$454.46 |
| 90688 |
|
29 |
23 |
$213.20 |
| 90734 |
|
20 |
13 |
$200.00 |
| 90715 |
|
19 |
12 |
$190.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
323 |
249 |
$69.60 |
| 97802 |
|
41 |
38 |
$34.60 |
| 90461 |
|
88 |
55 |
$0.00 |