| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
163 |
150 |
$8K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
65 |
59 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
29 |
29 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
28 |
28 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
116 |
51 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
97 |
90 |
$1K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
13 |
13 |
$1K |
| 87428 |
|
38 |
38 |
$1K |
| 99429 |
|
28 |
28 |
$519.80 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
43 |
32 |
$338.66 |
| 87807 |
|
25 |
25 |
$275.00 |
| 90461 |
|
52 |
43 |
$6.20 |
| 90633 |
|
18 |
18 |
$0.00 |
| 90670 |
|
25 |
25 |
$0.00 |
| 99173 |
|
20 |
20 |
$0.00 |
| 90710 |
|
16 |
16 |
$0.00 |
| 90681 |
|
13 |
13 |
$0.00 |
| 92552 |
|
13 |
13 |
$0.00 |
| 90697 |
|
14 |
14 |
$0.00 |