| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,726 |
1,920 |
$261K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
583 |
473 |
$32K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
329 |
280 |
$11K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
70 |
63 |
$7K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
266 |
91 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
276 |
209 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
29 |
28 |
$2K |
| 90651 |
|
22 |
20 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
19 |
15 |
$2K |
| Q3014 |
Telehealth originating site facility fee |
42 |
32 |
$792.29 |
| 90734 |
|
15 |
15 |
$697.05 |
| 90686 |
|
111 |
97 |
$550.76 |
| 90461 |
|
28 |
25 |
$466.34 |
| 90715 |
|
15 |
15 |
$238.05 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
17 |
12 |
$221.43 |
| 90672 |
|
15 |
14 |
$153.96 |
| 90685 |
|
16 |
15 |
$66.93 |