| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
604 |
543 |
$68K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
634 |
516 |
$51K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
71 |
68 |
$6K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
100 |
100 |
$4K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
34 |
34 |
$3K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
28 |
28 |
$3K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
26 |
26 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
119 |
119 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
72 |
71 |
$2K |
| 92567 |
|
92 |
92 |
$1K |
| 96127 |
|
110 |
110 |
$527.62 |
| 87428 |
|
13 |
13 |
$382.07 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
24 |
24 |
$352.80 |
| 90474 |
|
13 |
13 |
$238.42 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
27 |
26 |
$224.37 |
| 99173 |
|
87 |
87 |
$220.16 |
| 96161 |
|
42 |
41 |
$210.00 |
| 90670 |
|
67 |
67 |
$0.00 |
| 90698 |
|
60 |
60 |
$0.00 |
| 90680 |
|
26 |
26 |
$0.00 |
| 90744 |
|
16 |
16 |
$0.00 |