| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
400 |
386 |
$58K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
416 |
406 |
$41K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
487 |
286 |
$19K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
24 |
24 |
$3K |
| 96127 |
|
89 |
89 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
14 |
14 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
45 |
45 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
54 |
54 |
$935.91 |
| 90461 |
|
13 |
13 |
$595.32 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
12 |
12 |
$338.88 |
| 87081 |
|
25 |
25 |
$304.09 |