| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,365 |
2,506 |
$237K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,059 |
2,367 |
$136K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
986 |
686 |
$74K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
916 |
769 |
$67K |
| 96127 |
|
3,354 |
2,600 |
$57K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
762 |
601 |
$52K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
3,152 |
845 |
$50K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
595 |
427 |
$49K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
2,387 |
1,455 |
$39K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,397 |
1,123 |
$22K |
| 90651 |
|
34 |
12 |
$5K |
| 83655 |
|
393 |
297 |
$5K |
| 96160 |
|
322 |
271 |
$5K |
| 36416 |
|
1,099 |
865 |
$4K |
| 85018 |
|
1,135 |
882 |
$3K |
| 99381 |
|
28 |
25 |
$2K |
| Q3014 |
Telehealth originating site facility fee |
74 |
28 |
$2K |
| 99173 |
|
112 |
98 |
$826.95 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
26 |
25 |
$646.90 |
| 96111 |
|
80 |
24 |
$321.40 |
| 96161 |
|
148 |
148 |
$0.00 |
| 99000 |
|
15 |
15 |
$0.00 |
| 3210F |
|
12 |
12 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
55 |
44 |
$0.00 |
| 4274F |
|
32 |
26 |
$0.00 |
| 1003F |
|
12 |
12 |
$0.00 |