| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,849 |
2,430 |
$208K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,375 |
1,211 |
$64K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
67 |
55 |
$4K |
| 90686 |
|
390 |
376 |
$3K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
61 |
60 |
$3K |
| 90688 |
|
232 |
222 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
34 |
28 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
109 |
94 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
26 |
25 |
$364.00 |
| 90621 |
|
36 |
32 |
$256.00 |
| 90648 |
|
12 |
12 |
$88.00 |
| 3078F |
|
21 |
14 |
$0.00 |