| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,149 |
1,036 |
$126K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,580 |
1,511 |
$119K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,458 |
955 |
$34K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
281 |
281 |
$29K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
143 |
143 |
$15K |
| 90461 |
|
443 |
217 |
$13K |
| 87428 |
|
106 |
103 |
$8K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
111 |
111 |
$8K |
| 99460 |
|
78 |
77 |
$8K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
392 |
377 |
$7K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
464 |
443 |
$7K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
288 |
285 |
$6K |
| S9999 |
Sales tax |
524 |
433 |
$4K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
276 |
136 |
$4K |
| 99080 |
|
573 |
542 |
$4K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
25 |
25 |
$3K |
| 99072 |
|
171 |
164 |
$3K |
| 96160 |
|
321 |
296 |
$1K |
| 0071A |
|
32 |
30 |
$1K |
| 0072A |
|
29 |
28 |
$1K |
| 0001A |
|
19 |
19 |
$785.20 |
| 90480 |
|
14 |
14 |
$512.61 |
| 96127 |
|
42 |
27 |
$325.70 |
| 90686 |
|
501 |
501 |
$0.00 |
| 91307 |
|
60 |
50 |
$0.00 |
| 90656 |
|
21 |
19 |
$0.00 |
| 91300 |
|
29 |
20 |
$0.00 |
| 90756 |
|
46 |
46 |
$0.00 |