| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
700 |
579 |
$30K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
668 |
564 |
$21K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
439 |
249 |
$5K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
161 |
69 |
$2K |
| 0071A |
|
36 |
33 |
$1K |
| 99215 |
Prolong outpt/office vis |
15 |
13 |
$997.44 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
77 |
70 |
$752.61 |
| 0001A |
|
21 |
16 |
$572.00 |
| 0072A |
|
18 |
15 |
$296.72 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
36 |
25 |
$196.04 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
23 |
23 |
$147.40 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
19 |
18 |
$116.04 |
| 90461 |
|
25 |
18 |
$78.77 |
| 96160 |
|
35 |
26 |
$51.86 |
| 92551 |
|
24 |
14 |
$27.16 |
| 97802 |
|
51 |
27 |
$0.00 |
| 91307 |
|
51 |
48 |
$0.00 |
| 90686 |
|
111 |
103 |
$0.00 |
| 99173 |
|
32 |
28 |
$0.00 |
| 90734 |
|
19 |
18 |
$0.00 |
| 90715 |
|
21 |
20 |
$0.00 |