| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
286 |
267 |
$16K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
325 |
303 |
$14K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
294 |
137 |
$5K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
49 |
48 |
$2K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
17 |
17 |
$442.24 |
| 90677 |
|
24 |
24 |
$0.00 |
| 90697 |
|
12 |
12 |
$0.00 |
| 90656 |
|
13 |
13 |
$0.00 |
| 90680 |
|
12 |
12 |
$0.00 |