| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,025 |
854 |
$115K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
689 |
529 |
$53K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,159 |
554 |
$14K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
102 |
89 |
$9K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
80 |
69 |
$8K |
| 99384 |
|
115 |
55 |
$7K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
52 |
51 |
$6K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
148 |
123 |
$4K |
| 90461 |
|
297 |
167 |
$4K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
622 |
450 |
$4K |
| 96127 |
|
1,480 |
998 |
$4K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
45 |
41 |
$4K |
| 99383 |
|
70 |
29 |
$3K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
35 |
25 |
$3K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
26 |
26 |
$3K |
| 96116 |
|
33 |
26 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
102 |
69 |
$942.69 |
| 99401 |
|
72 |
64 |
$780.00 |
| 96160 |
|
310 |
266 |
$500.33 |
| 90480 |
|
28 |
16 |
$440.00 |
| 99406 |
|
46 |
41 |
$346.84 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
15 |
13 |
$229.04 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
21 |
13 |
$137.72 |
| 94760 |
|
12 |
12 |
$24.96 |
| 90686 |
|
174 |
105 |
$0.00 |
| 90651 |
|
16 |
16 |
$0.00 |
| 99000 |
|
14 |
12 |
$0.00 |
| 90619 |
|
13 |
12 |
$0.00 |
| 90660 |
|
22 |
20 |
$0.00 |
| 1000F |
|
37 |
37 |
$0.00 |
| 3085F |
|
95 |
88 |
$0.00 |
| 90661 |
|
131 |
121 |
$0.00 |