| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,336 |
1,109 |
$110K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,004 |
1,600 |
$105K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
249 |
189 |
$20K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
127 |
120 |
$10K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
520 |
455 |
$10K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
79 |
73 |
$7K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
101 |
67 |
$7K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
170 |
144 |
$3K |
| 90670 |
|
118 |
97 |
$1K |
| 99000 |
|
125 |
120 |
$1K |
| 90686 |
|
97 |
88 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
23 |
12 |
$1K |
| 90648 |
|
83 |
70 |
$908.24 |
| 96160 |
|
81 |
77 |
$810.00 |
| 90723 |
|
47 |
40 |
$646.28 |
| 90619 |
|
13 |
12 |
$360.25 |
| 90656 |
|
15 |
13 |
$274.61 |
| 90633 |
|
14 |
14 |
$237.28 |
| 36416 |
|
14 |
12 |
$19.68 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
192 |
150 |
$0.00 |
| 99072 |
|
424 |
286 |
$0.00 |
| 90461 |
|
24 |
17 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
20 |
17 |
$0.00 |