| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,035 |
1,558 |
$110K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
628 |
568 |
$27K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
83 |
82 |
$6K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
86 |
84 |
$6K |
| 92552 |
|
147 |
144 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
192 |
191 |
$2K |
| 36410 |
|
119 |
114 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
15 |
15 |
$268.24 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
13 |
13 |
$254.00 |
| 90658 |
|
39 |
38 |
$162.90 |
| 94760 |
|
23 |
16 |
$0.00 |