| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
503 |
495 |
$49K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
905 |
902 |
$49K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
744 |
720 |
$49K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
402 |
360 |
$37K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
295 |
295 |
$30K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
178 |
178 |
$17K |
| 99058 |
|
368 |
353 |
$7K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
158 |
157 |
$6K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
41 |
41 |
$4K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
130 |
129 |
$3K |
| 99460 |
|
27 |
26 |
$2K |
| 94010 |
|
68 |
67 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
172 |
171 |
$2K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
25 |
24 |
$2K |
| 92567 |
|
97 |
91 |
$1K |
| 36416 |
|
208 |
204 |
$827.58 |
| 83655 |
|
74 |
74 |
$743.30 |
| 92587 |
|
468 |
466 |
$239.53 |
| 92015 |
Determination of refractive state |
341 |
341 |
$225.83 |
| 90651 |
|
24 |
24 |
$208.84 |
| 96127 |
|
45 |
45 |
$208.28 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
29 |
29 |
$203.50 |
| 85018 |
|
91 |
91 |
$174.67 |
| 81002 |
|
12 |
12 |
$21.19 |
| 90744 |
|
119 |
119 |
$0.00 |
| 90680 |
|
157 |
157 |
$0.00 |
| 90686 |
|
262 |
261 |
$0.00 |
| 90716 |
|
91 |
91 |
$0.00 |
| 90700 |
|
290 |
290 |
$0.00 |
| 90685 |
|
110 |
109 |
$0.00 |
| 90713 |
|
227 |
227 |
$0.00 |
| 90670 |
|
238 |
238 |
$0.00 |
| 90633 |
|
131 |
131 |
$0.00 |
| 90648 |
|
236 |
236 |
$0.00 |
| 90707 |
|
87 |
87 |
$0.00 |