| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
236 |
201 |
$17K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
108 |
86 |
$5K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
50 |
43 |
$4K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
188 |
94 |
$4K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
146 |
113 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
105 |
92 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
27 |
27 |
$2K |
| 96127 |
|
67 |
61 |
$954.30 |
| 87807 |
|
49 |
32 |
$494.28 |
| 90648 |
|
14 |
13 |
$85.12 |
| 90670 |
|
12 |
12 |
$72.32 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
39 |
35 |
$0.00 |
| 90461 |
|
15 |
14 |
$0.00 |