| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
290 |
257 |
$23K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
151 |
146 |
$8K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
83 |
69 |
$5K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
41 |
38 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
34 |
30 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
226 |
168 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
94 |
45 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
63 |
62 |
$858.45 |
| 92551 |
|
53 |
51 |
$545.38 |
| 83655 |
|
31 |
25 |
$366.75 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
195 |
177 |
$341.09 |
| 99174 |
|
45 |
42 |
$274.82 |
| 90461 |
|
128 |
113 |
$164.80 |
| 85014 |
|
58 |
47 |
$132.48 |
| 99173 |
|
40 |
38 |
$75.11 |
| 36416 |
|
93 |
73 |
$52.80 |
| 94760 |
|
36 |
32 |
$2.82 |
| 99000 |
|
28 |
27 |
$0.00 |