| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,293 |
1,247 |
$94K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,608 |
1,549 |
$81K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,532 |
1,508 |
$75K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
607 |
555 |
$44K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
493 |
481 |
$37K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
366 |
364 |
$28K |
| 99058 |
|
1,043 |
1,007 |
$17K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
125 |
124 |
$11K |
| 94010 |
|
305 |
300 |
$8K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
375 |
365 |
$7K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
223 |
218 |
$6K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
539 |
534 |
$6K |
| 92567 |
|
424 |
395 |
$4K |
| 83655 |
|
176 |
170 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
181 |
181 |
$1K |
| 99383 |
|
12 |
12 |
$979.62 |
| 36416 |
|
325 |
317 |
$900.85 |
| 96127 |
|
210 |
203 |
$804.43 |
| 92015 |
Determination of refractive state |
713 |
686 |
$684.16 |
| 69210 |
|
29 |
29 |
$539.64 |
| 93000 |
|
34 |
34 |
$445.99 |
| 85018 |
|
193 |
187 |
$371.27 |
| 92587 |
|
965 |
933 |
$342.97 |
| 90651 |
|
83 |
83 |
$242.00 |
| 94664 |
|
15 |
15 |
$183.85 |
| 81002 |
|
26 |
26 |
$56.09 |
| 94760 |
|
39 |
37 |
$51.60 |
| 90670 |
|
440 |
430 |
$0.00 |
| 90685 |
|
202 |
201 |
$0.00 |
| 90648 |
|
434 |
426 |
$0.00 |
| 90707 |
|
199 |
191 |
$0.00 |
| 90633 |
|
221 |
215 |
$0.00 |
| 90713 |
|
445 |
439 |
$0.00 |
| 90715 |
|
17 |
17 |
$0.00 |
| 90700 |
|
527 |
518 |
$0.00 |
| 90734 |
|
47 |
47 |
$0.00 |
| 90716 |
|
199 |
191 |
$0.00 |
| 90680 |
|
281 |
279 |
$0.00 |
| 90744 |
|
247 |
245 |
$0.00 |
| 90686 |
|
493 |
488 |
$0.00 |
| 99000 |
|
12 |
12 |
$0.00 |