| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
794 |
703 |
$58K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
861 |
798 |
$43K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
940 |
913 |
$33K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
69 |
67 |
$5K |
| 90461 |
|
109 |
108 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
25 |
24 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
12 |
12 |
$795.34 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
13 |
12 |
$192.21 |
| 92552 |
|
14 |
14 |
$74.12 |
| 94760 |
|
698 |
590 |
$24.12 |
| 99173 |
|
42 |
41 |
$4.62 |
| 90686 |
|
118 |
110 |
$0.00 |
| 90688 |
|
89 |
85 |
$0.00 |
| 99072 |
|
115 |
105 |
$0.00 |
| 90670 |
|
14 |
13 |
$0.00 |