| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
451 |
346 |
$19K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
384 |
329 |
$11K |
| 92552 |
|
181 |
151 |
$3K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
398 |
312 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
17 |
13 |
$1K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
108 |
78 |
$998.40 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
102 |
45 |
$734.82 |
| 90461 |
|
45 |
30 |
$97.98 |
| 99173 |
|
205 |
146 |
$9.36 |
| 96127 |
|
25 |
17 |
$0.00 |