| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
717 |
613 |
$58K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
184 |
182 |
$13K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
165 |
138 |
$9K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
517 |
507 |
$7K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
25 |
25 |
$2K |
| 97802 |
|
468 |
463 |
$1K |
| 96127 |
|
223 |
220 |
$1K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
15 |
15 |
$231.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
15 |
15 |
$197.70 |
| 3008F |
|
664 |
653 |
$2.97 |
| 2000F |
|
621 |
613 |
$2.93 |
| 1220F |
|
73 |
73 |
$0.03 |
| 3016F |
|
73 |
73 |
$0.03 |
| 90686 |
|
130 |
129 |
$0.00 |
| 4293F |
|
26 |
26 |
$0.00 |
| 1000F |
|
26 |
26 |
$0.00 |
| 99173 |
|
71 |
70 |
$0.00 |