| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
123 |
115 |
$11K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
159 |
137 |
$9K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
427 |
368 |
$7K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
87 |
72 |
$6K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
74 |
38 |
$1K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
12 |
12 |
$935.04 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
57 |
56 |
$763.02 |
| 99199 |
Unlisted special service, procedure or report |
89 |
89 |
$405.00 |
| 92552 |
|
132 |
109 |
$44.30 |
| 99173 |
|
148 |
123 |
$13.00 |
| 90686 |
|
111 |
90 |
$0.00 |