| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,850 |
170 |
$98K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,548 |
102 |
$35K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
213 |
14 |
$9K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,156 |
85 |
$70.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,209 |
88 |
$0.00 |
| 92587 |
|
447 |
28 |
$0.00 |
| 81000 |
|
450 |
29 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
203 |
14 |
$0.00 |
| 90461 |
|
206 |
14 |
$0.00 |
| 99173 |
|
395 |
26 |
$0.00 |