| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,046 |
921 |
$76K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
233 |
213 |
$11K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
105 |
96 |
$9K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
67 |
67 |
$6K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
62 |
56 |
$5K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
238 |
232 |
$4K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
525 |
497 |
$4K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
145 |
131 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
25 |
25 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
235 |
231 |
$1K |
| 81002 |
|
369 |
351 |
$1K |
| 85018 |
|
76 |
74 |
$204.75 |
| 99173 |
|
292 |
273 |
$51.30 |
| 90686 |
|
219 |
205 |
$16.87 |
| 90651 |
|
14 |
12 |
$0.00 |
| 90700 |
|
43 |
43 |
$0.00 |
| 90670 |
|
13 |
13 |
$0.00 |
| 90648 |
|
14 |
14 |
$0.00 |
| 90713 |
|
14 |
14 |
$0.00 |
| 90685 |
|
15 |
15 |
$0.00 |