| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,101 |
1,681 |
$171K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,588 |
1,145 |
$82K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
561 |
426 |
$44K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
344 |
242 |
$24K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
264 |
212 |
$21K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,014 |
819 |
$18K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
150 |
128 |
$13K |
| 90670 |
|
322 |
225 |
$3K |
| 90648 |
|
271 |
183 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
151 |
100 |
$3K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
94 |
43 |
$2K |
| 90686 |
|
149 |
129 |
$2K |
| 90677 |
|
41 |
41 |
$1K |
| 90723 |
|
97 |
74 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
26 |
13 |
$1K |
| 36416 |
|
194 |
122 |
$591.02 |
| 99000 |
|
58 |
39 |
$580.00 |
| 90633 |
|
27 |
24 |
$446.23 |
| 96160 |
|
33 |
31 |
$330.00 |
| 85018 |
|
118 |
84 |
$287.10 |
| 90656 |
|
14 |
14 |
$268.80 |
| 90619 |
|
13 |
13 |
$218.90 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
439 |
304 |
$182.14 |
| 90651 |
|
28 |
13 |
$154.56 |
| 99072 |
|
437 |
268 |
$0.00 |
| 90461 |
|
48 |
39 |
$0.00 |