| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
327 |
309 |
$27K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
341 |
304 |
$19K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
91 |
63 |
$5K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
45 |
37 |
$3K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
30 |
25 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
271 |
184 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
103 |
52 |
$1K |
| 92551 |
|
157 |
129 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
95 |
89 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
14 |
14 |
$1K |
| 90734 |
|
17 |
13 |
$489.97 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
253 |
210 |
$417.40 |
| 83655 |
|
44 |
28 |
$410.76 |
| 99173 |
|
130 |
107 |
$253.82 |
| 99174 |
|
64 |
45 |
$241.62 |
| 85014 |
|
82 |
59 |
$169.92 |
| 90461 |
|
115 |
86 |
$151.70 |
| 36416 |
|
99 |
76 |
$44.00 |
| 94760 |
|
26 |
26 |
$2.82 |
| 99000 |
|
72 |
67 |
$0.00 |