| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
115 |
109 |
$10K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
77 |
69 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
30 |
30 |
$3K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
43 |
42 |
$563.02 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
33 |
32 |
$444.57 |
| 96127 |
|
52 |
52 |
$422.12 |
| 96160 |
|
18 |
18 |
$144.53 |