| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
9,223 |
8,269 |
$494K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,078 |
2,865 |
$139K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
640 |
617 |
$34K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
137 |
134 |
$12K |
| 0064A |
|
80 |
78 |
$4K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
32 |
30 |
$3K |
| 0012A |
|
70 |
70 |
$2K |
| 0011A |
|
52 |
52 |
$2K |
| 0134A |
|
29 |
29 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
31 |
31 |
$735.11 |
| 90674 |
|
18 |
18 |
$347.52 |
| 90686 |
|
30 |
28 |
$200.91 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
12 |
12 |
$124.27 |
| 90656 |
|
17 |
17 |
$22.35 |
| 3078F |
|
329 |
313 |
$0.00 |
| 3074F |
|
479 |
461 |
$0.00 |
| 3079F |
|
12 |
12 |
$0.00 |
| 91301 |
|
89 |
88 |
$0.00 |