| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,430 |
2,100 |
$111K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
724 |
680 |
$64K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,786 |
1,531 |
$53K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
475 |
407 |
$38K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
168 |
165 |
$14K |
| 99188 |
|
150 |
142 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
220 |
204 |
$1K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
66 |
59 |
$1K |
| 90686 |
|
309 |
301 |
$500.00 |
| 96160 |
|
120 |
119 |
$480.24 |
| 90670 |
|
99 |
94 |
$380.00 |
| 99429 |
|
16 |
16 |
$375.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
154 |
95 |
$340.00 |
| 90648 |
|
108 |
108 |
$250.00 |
| 99072 |
|
270 |
228 |
$151.20 |
| 96161 |
|
35 |
14 |
$121.80 |
| 99056 |
|
31 |
26 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
123 |
73 |
$0.00 |
| 90723 |
|
14 |
14 |
$0.00 |
| 90656 |
|
57 |
56 |
$0.00 |
| 90461 |
|
57 |
29 |
$0.00 |