| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
482 |
410 |
$22K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
12 |
12 |
$841.47 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
218 |
142 |
$240.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
30 |
24 |
$136.25 |
| 99173 |
|
154 |
128 |
$53.19 |
| 90686 |
|
14 |
12 |
$10.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
13 |
12 |
$0.00 |