| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
209 |
193 |
$17K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
176 |
169 |
$10K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
72 |
72 |
$6K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
41 |
41 |
$3K |
| 90461 |
|
170 |
170 |
$3K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
251 |
251 |
$3K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
76 |
37 |
$764.42 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
13 |
13 |
$73.97 |
| 90686 |
|
40 |
40 |
$32.84 |
| G9153 |
Mapcp demonstration - physician incentive pool |
189 |
187 |
$0.00 |
| 90716 |
|
12 |
12 |
$0.00 |
| 94760 |
|
41 |
40 |
$0.00 |
| 90698 |
|
12 |
12 |
$0.00 |
| 90670 |
|
16 |
16 |
$0.00 |
| 90707 |
|
12 |
12 |
$0.00 |