| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
971 |
915 |
$54K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,403 |
1,324 |
$50K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
13 |
13 |
$888.50 |
| 92551 |
|
118 |
118 |
$547.31 |
| 90682 |
|
13 |
13 |
$442.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$423.50 |
| 99173 |
|
118 |
118 |
$307.50 |
| G0008 |
Administration of influenza virus vaccine |
14 |
13 |
$143.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
12 |
12 |
$91.91 |
| 83655 |
|
12 |
12 |
$44.00 |
| 96127 |
|
13 |
13 |
$0.00 |
| 96160 |
|
14 |
14 |
$0.00 |