| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,607 |
2,284 |
$206K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
375 |
312 |
$26K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
235 |
205 |
$18K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
138 |
126 |
$6K |
| 90686 |
|
231 |
225 |
$3K |
| 90670 |
|
124 |
122 |
$2K |
| 90656 |
|
95 |
95 |
$2K |
| 87430 |
|
93 |
91 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
40 |
40 |
$628.00 |
| 90677 |
|
32 |
26 |
$536.72 |
| 90697 |
|
25 |
25 |
$420.75 |
| 90698 |
|
25 |
24 |
$286.22 |
| 90680 |
|
12 |
12 |
$201.52 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
50 |
39 |
$0.00 |