| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
268 |
260 |
$28K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
291 |
258 |
$21K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
101 |
101 |
$10K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
93 |
93 |
$10K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
72 |
72 |
$8K |
| 97802 |
|
238 |
238 |
$6K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
345 |
345 |
$4K |
| 90461 |
|
165 |
165 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
159 |
158 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
119 |
73 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
128 |
128 |
$910.08 |
| 99188 |
|
27 |
27 |
$437.40 |
| 90686 |
|
183 |
183 |
$0.00 |
| 90651 |
|
17 |
17 |
$0.00 |
| 90647 |
|
12 |
12 |
$0.00 |
| 90670 |
|
27 |
27 |
$0.00 |