| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,901 |
3,456 |
$182K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
674 |
606 |
$23K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
299 |
298 |
$19K |
| 99215 |
Prolong outpt/office vis |
247 |
236 |
$16K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
142 |
140 |
$10K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
31 |
31 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
294 |
287 |
$2K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
158 |
87 |
$1K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
16 |
16 |
$986.89 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
35 |
35 |
$938.16 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
44 |
32 |
$275.34 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
26 |
26 |
$203.50 |
| 81001 |
|
69 |
67 |
$149.90 |
| 90715 |
|
14 |
14 |
$0.00 |
| 90734 |
|
17 |
17 |
$0.00 |
| 90656 |
|
63 |
61 |
$0.00 |