| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,081 |
1,021 |
$109K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
780 |
753 |
$80K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
199 |
199 |
$17K |
| 87400 |
|
138 |
137 |
$7K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
238 |
233 |
$6K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
16 |
16 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
13 |
13 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
12 |
12 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
12 |
12 |
$2K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
41 |
13 |
$2K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
15 |
15 |
$1K |
| 90461 |
|
15 |
15 |
$1K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
13 |
13 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
44 |
44 |
$955.24 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
12 |
12 |
$584.92 |
| G0008 |
Administration of influenza virus vaccine |
45 |
45 |
$0.00 |
| Q2038 |
Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluzone) |
12 |
12 |
$0.00 |