| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,561 |
1,326 |
$103K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,499 |
1,297 |
$67K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
868 |
820 |
$12K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
44 |
44 |
$4K |
| 92587 |
|
330 |
292 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
33 |
26 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
82 |
57 |
$536.60 |
| 90656 |
|
26 |
26 |
$531.44 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
111 |
101 |
$512.31 |
| 90686 |
|
76 |
62 |
$497.80 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
55 |
54 |
$461.62 |
| 99174 |
|
294 |
261 |
$107.06 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
12 |
12 |
$58.54 |