| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
837 |
777 |
$41K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
281 |
260 |
$21K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
453 |
420 |
$16K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
212 |
210 |
$16K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,287 |
658 |
$10K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
99 |
98 |
$8K |
| 90461 |
|
364 |
324 |
$3K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
403 |
323 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
25 |
25 |
$2K |
| 99381 |
|
13 |
13 |
$916.92 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
70 |
68 |
$906.71 |
| A4208 |
Syringe with needle, sterile 3 cc, each |
1,162 |
656 |
$330.28 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
25 |
25 |
$278.54 |
| 96160 |
|
27 |
27 |
$52.84 |
| 90698 |
|
48 |
47 |
$0.00 |
| 90686 |
|
96 |
96 |
$0.00 |
| 99070 |
|
31 |
29 |
$0.00 |
| 90744 |
|
28 |
28 |
$0.00 |
| 90716 |
|
12 |
12 |
$0.00 |
| 90670 |
|
95 |
95 |
$0.00 |
| 90700 |
|
16 |
15 |
$0.00 |
| 90681 |
|
31 |
31 |
$0.00 |
| 90707 |
|
12 |
12 |
$0.00 |