| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,305 |
1,200 |
$130K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
652 |
615 |
$46K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
774 |
771 |
$36K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
342 |
339 |
$28K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
182 |
182 |
$16K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
57 |
57 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
37 |
37 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
129 |
126 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
51 |
50 |
$1K |
| 96161 |
|
167 |
167 |
$775.00 |
| 90647 |
|
138 |
138 |
$0.00 |
| 90680 |
|
119 |
119 |
$0.00 |
| 90723 |
|
109 |
109 |
$0.00 |
| 90656 |
|
15 |
15 |
$0.00 |
| 90686 |
|
89 |
89 |
$0.00 |
| 90670 |
|
182 |
182 |
$0.00 |
| 90671 |
|
38 |
38 |
$0.00 |