| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
192 |
178 |
$15K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
249 |
236 |
$13K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
45 |
29 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
140 |
70 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
16 |
16 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
85 |
82 |
$1K |
| 90686 |
|
54 |
53 |
$692.67 |
| 87081 |
|
80 |
77 |
$565.47 |
| 90734 |
|
16 |
16 |
$537.06 |
| 90651 |
|
12 |
12 |
$313.64 |
| 81002 |
|
99 |
75 |
$230.14 |
| 90633 |
|
24 |
13 |
$226.92 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
15 |
15 |
$133.65 |
| 85018 |
|
61 |
39 |
$109.44 |
| 82465 |
|
29 |
12 |
$58.08 |
| 99173 |
|
15 |
15 |
$38.85 |
| 36416 |
|
83 |
50 |
$0.00 |