| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
137 |
126 |
$11K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
103 |
98 |
$6K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
21 |
20 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
17 |
14 |
$1K |
| 92551 |
|
86 |
81 |
$834.44 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
97 |
86 |
$405.51 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
56 |
39 |
$385.11 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
23 |
12 |
$334.65 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
12 |
12 |
$174.60 |
| 90461 |
|
13 |
13 |
$128.60 |
| 90651 |
|
13 |
13 |
$123.20 |
| 99173 |
|
40 |
39 |
$80.29 |
| 85014 |
|
17 |
12 |
$34.56 |
| 36416 |
|
17 |
12 |
$6.60 |
| 94760 |
|
16 |
13 |
$0.00 |