| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
381 |
334 |
$20K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
551 |
485 |
$20K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
667 |
290 |
$9K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
81 |
77 |
$7K |
| 87428 |
|
115 |
106 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
33 |
33 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
14 |
14 |
$1K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
16 |
14 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
73 |
65 |
$869.55 |
| 99000 |
|
55 |
55 |
$515.30 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
24 |
12 |
$346.20 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
35 |
26 |
$254.61 |
| 96160 |
|
696 |
413 |
$170.79 |
| 92551 |
|
119 |
119 |
$137.42 |
| 92587 |
|
54 |
51 |
$94.84 |
| 90461 |
|
90 |
75 |
$1.20 |
| 90677 |
|
25 |
25 |
$0.07 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
125 |
125 |
$0.01 |
| 90686 |
|
28 |
28 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
16 |
16 |
$0.00 |
| 90656 |
|
13 |
13 |
$0.00 |
| 1033F |
|
420 |
397 |
$0.00 |
| 99173 |
|
58 |
58 |
$0.00 |
| 99177 |
|
25 |
25 |
$0.00 |