| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,168 |
3,896 |
$372K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,261 |
2,137 |
$148K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
637 |
637 |
$58K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
3,015 |
2,985 |
$54K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
610 |
584 |
$52K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,315 |
1,311 |
$37K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
336 |
336 |
$30K |
| 92567 |
|
757 |
710 |
$10K |
| 96127 |
|
1,178 |
1,174 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
41 |
41 |
$4K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
173 |
167 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
294 |
293 |
$2K |
| 90474 |
|
124 |
124 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
12 |
12 |
$2K |
| 83655 |
|
130 |
130 |
$1K |
| 92551 |
|
154 |
152 |
$1K |
| 99188 |
|
113 |
113 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
87 |
87 |
$1K |
| 99460 |
|
13 |
13 |
$1K |
| 99462 |
|
24 |
14 |
$995.28 |
| 85018 |
|
315 |
314 |
$713.04 |
| 87428 |
|
19 |
18 |
$558.41 |
| 99173 |
|
231 |
231 |
$526.42 |
| 90473 |
|
14 |
14 |
$256.76 |
| 96161 |
|
12 |
12 |
$60.00 |
| 90670 |
|
335 |
335 |
$0.00 |
| 90633 |
|
55 |
55 |
$0.00 |
| 90672 |
|
27 |
27 |
$0.00 |
| 90658 |
|
12 |
12 |
$0.00 |
| 90707 |
|
12 |
12 |
$0.00 |
| 90698 |
|
310 |
310 |
$0.00 |
| 90744 |
|
15 |
15 |
$0.00 |
| 90686 |
|
441 |
441 |
$0.00 |
| 90688 |
|
735 |
735 |
$0.00 |
| 90680 |
|
139 |
139 |
$0.00 |
| 90716 |
|
12 |
12 |
$0.00 |