| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
253 |
237 |
$22K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
287 |
260 |
$16K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
161 |
149 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
22 |
22 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
17 |
17 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
151 |
148 |
$1K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
12 |
12 |
$899.31 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
36 |
17 |
$503.10 |
| 92551 |
|
29 |
28 |
$273.06 |
| 90723 |
|
12 |
12 |
$201.05 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
129 |
123 |
$168.50 |
| 90633 |
|
14 |
12 |
$137.50 |
| 99173 |
|
54 |
52 |
$132.09 |
| 90461 |
|
70 |
68 |
$64.52 |
| 85018 |
|
17 |
17 |
$43.84 |
| 36416 |
|
15 |
15 |
$1.10 |
| 99000 |
|
165 |
154 |
$0.00 |