| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
490 |
474 |
$34K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
627 |
594 |
$30K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
100 |
100 |
$8K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
56 |
56 |
$5K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
46 |
46 |
$4K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
64 |
63 |
$941.26 |
| 99177 |
|
25 |
25 |
$52.86 |
| 96127 |
|
31 |
31 |
$30.80 |
| 96160 |
|
31 |
31 |
$26.80 |
| G9920 |
Screening performed and negative |
170 |
170 |
$0.00 |
| 90661 |
|
45 |
45 |
$0.00 |
| 90648 |
|
26 |
25 |
$0.00 |
| 90686 |
|
48 |
48 |
$0.00 |
| 90677 |
|
26 |
25 |
$0.00 |
| 92551 |
|
12 |
12 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
14 |
14 |
$0.00 |