| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,733 |
1,463 |
$102K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
638 |
538 |
$21K |
| 95165 |
Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials |
93 |
38 |
$12K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
146 |
131 |
$9K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
78 |
76 |
$6K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
64 |
52 |
$4K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
104 |
99 |
$3K |
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
17 |
13 |
$2K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
18 |
17 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
75 |
72 |
$851.85 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
28 |
28 |
$370.88 |
| 83655 |
|
18 |
16 |
$189.12 |
| 85018 |
|
34 |
30 |
$75.95 |
| 90670 |
|
31 |
27 |
$0.00 |
| 90658 |
|
36 |
30 |
$0.00 |
| 90686 |
|
70 |
66 |
$0.00 |