| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,257 |
1,037 |
$90K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,046 |
886 |
$81K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,747 |
1,420 |
$79K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
866 |
693 |
$57K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,045 |
888 |
$50K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
304 |
274 |
$23K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
581 |
497 |
$17K |
| 96161 |
|
755 |
571 |
$11K |
| 99177 |
|
1,103 |
947 |
$7K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
878 |
719 |
$7K |
| 92551 |
|
580 |
509 |
$5K |
| 83655 |
|
343 |
274 |
$4K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
141 |
134 |
$2K |
| 3008F |
|
766 |
674 |
$2K |
| 99381 |
|
29 |
20 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
14 |
14 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
117 |
107 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
15 |
14 |
$1K |
| 36416 |
|
750 |
605 |
$1K |
| 90716 |
|
189 |
149 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
60 |
54 |
$730.98 |
| 90707 |
|
179 |
139 |
$675.74 |
| 90670 |
|
737 |
580 |
$490.75 |
| 96127 |
|
61 |
52 |
$305.05 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
21 |
12 |
$293.81 |
| 99173 |
|
45 |
45 |
$282.20 |
| 90633 |
|
390 |
317 |
$212.75 |
| 90696 |
|
31 |
28 |
$137.03 |
| 90686 |
|
651 |
556 |
$133.50 |
| 90647 |
|
527 |
413 |
$104.40 |
| 82465 |
|
69 |
58 |
$86.82 |
| 90680 |
|
464 |
353 |
$0.00 |
| 90723 |
|
539 |
417 |
$0.00 |
| 90700 |
|
22 |
16 |
$0.00 |
| 90685 |
|
103 |
96 |
$0.00 |