| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,180 |
1,743 |
$80K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
160 |
139 |
$11K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
116 |
101 |
$9K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
92 |
71 |
$6K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
294 |
233 |
$6K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
318 |
272 |
$3K |
| 92552 |
|
986 |
812 |
$1K |
| 90688 |
|
96 |
96 |
$1K |
| 99173 |
|
1,094 |
951 |
$1K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
27 |
13 |
$1K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
58 |
48 |
$695.87 |
| 90700 |
|
99 |
98 |
$605.00 |
| 90713 |
|
77 |
77 |
$429.00 |
| 92551 |
|
168 |
134 |
$198.00 |
| 96127 |
|
217 |
192 |
$150.80 |
| 90670 |
|
12 |
12 |
$120.00 |
| 90734 |
|
46 |
44 |
$50.00 |
| 81003 |
|
209 |
164 |
$41.85 |
| 81000 |
|
48 |
41 |
$30.67 |
| 96161 |
|
16 |
14 |
$11.49 |
| 96160 |
|
172 |
147 |
$3.48 |
| 90707 |
|
26 |
26 |
$0.00 |
| 90461 |
|
15 |
14 |
$0.00 |
| 90648 |
|
16 |
12 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
18 |
16 |
$0.00 |
| 90716 |
|
13 |
13 |
$0.00 |
| 87070 |
|
18 |
16 |
$0.00 |