| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,878 |
3,668 |
$368K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,220 |
3,104 |
$225K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,247 |
1,175 |
$108K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
833 |
833 |
$77K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,607 |
1,607 |
$56K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,958 |
2,951 |
$53K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
90 |
90 |
$8K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
24 |
24 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
14 |
14 |
$1K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
15 |
15 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
32 |
32 |
$897.92 |
| 90474 |
|
29 |
29 |
$531.86 |
| 0071A |
|
12 |
12 |
$480.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
39 |
39 |
$345.78 |
| 96381 |
|
13 |
13 |
$222.86 |
| 83655 |
|
15 |
15 |
$161.55 |
| 90686 |
|
500 |
499 |
$140.12 |
| 85018 |
|
27 |
27 |
$60.57 |
| 90656 |
|
76 |
76 |
$0.03 |
| 90680 |
|
29 |
29 |
$0.00 |
| 90723 |
|
150 |
150 |
$0.00 |
| 90647 |
|
152 |
152 |
$0.00 |
| 90677 |
|
15 |
15 |
$0.00 |
| 90670 |
|
238 |
238 |
$0.00 |
| 90681 |
|
30 |
30 |
$0.00 |
| 90671 |
|
13 |
13 |
$0.00 |
| 90633 |
|
12 |
12 |
$0.00 |