| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
429 |
355 |
$24K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
129 |
109 |
$3K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
31 |
27 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
59 |
59 |
$598.36 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
81 |
80 |
$314.13 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
45 |
42 |
$145.23 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
30 |
29 |
$96.35 |
| 90670 |
|
12 |
12 |
$0.00 |