| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
9,305 |
8,304 |
$837K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,606 |
1,517 |
$107K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
367 |
367 |
$35K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
605 |
597 |
$17K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
405 |
405 |
$15K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
605 |
591 |
$9K |
| 36415 |
Collection of venous blood by venipuncture |
1,524 |
1,472 |
$7K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
30 |
30 |
$3K |
| 96127 |
|
513 |
513 |
$2K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
57 |
57 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
255 |
254 |
$2K |
| 99408 |
|
53 |
52 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
12 |
12 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
12 |
12 |
$1K |
| 99173 |
|
302 |
302 |
$750.43 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
16 |
16 |
$339.46 |
| 90686 |
|
75 |
75 |
$34.07 |
| 96160 |
|
235 |
234 |
$0.00 |