| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
377 |
339 |
$31K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
478 |
444 |
$27K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
167 |
162 |
$13K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
99 |
97 |
$8K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
179 |
165 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
81 |
74 |
$2K |
| 92551 |
|
163 |
160 |
$2K |
| 90686 |
|
129 |
128 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
17 |
17 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
12 |
12 |
$916.80 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
278 |
265 |
$730.38 |
| 90670 |
|
41 |
39 |
$585.55 |
| 90716 |
|
12 |
12 |
$483.36 |
| 90461 |
|
141 |
134 |
$408.30 |
| 99188 |
|
14 |
14 |
$305.62 |
| 99173 |
|
106 |
104 |
$266.77 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
28 |
28 |
$229.46 |
| 90633 |
|
13 |
13 |
$187.00 |
| 96127 |
|
34 |
32 |
$171.27 |
| 90707 |
|
15 |
15 |
$165.00 |
| 90647 |
|
14 |
14 |
$154.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
27 |
27 |
$92.40 |