| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,630 |
2,033 |
$219K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
851 |
697 |
$63K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
116 |
96 |
$10K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
102 |
82 |
$7K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
101 |
79 |
$7K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,530 |
1,183 |
$6K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
948 |
724 |
$5K |
| 90686 |
|
357 |
269 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
26 |
25 |
$3K |
| 90461 |
|
457 |
350 |
$2K |
| 90670 |
|
70 |
52 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
48 |
45 |
$275.88 |
| 90698 |
|
17 |
13 |
$256.08 |
| 90680 |
|
16 |
12 |
$232.80 |
| 90649 |
|
15 |
12 |
$93.12 |
| 87420 |
|
12 |
12 |
$56.29 |