| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,359 |
2,181 |
$238K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,339 |
2,212 |
$157K |
| 96112 |
|
936 |
934 |
$112K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,075 |
2,038 |
$69K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
728 |
728 |
$67K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
615 |
615 |
$57K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
412 |
408 |
$35K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
172 |
172 |
$18K |
| 92551 |
|
913 |
913 |
$9K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
266 |
262 |
$6K |
| 96127 |
|
1,389 |
1,389 |
$6K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
379 |
373 |
$5K |
| 99383 |
|
19 |
19 |
$2K |
| 92567 |
|
107 |
100 |
$1K |
| 99442 |
|
25 |
24 |
$1K |
| 99173 |
|
423 |
423 |
$1K |
| 96113 |
|
13 |
13 |
$723.30 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
44 |
44 |
$362.40 |
| 87807 |
|
15 |
15 |
$177.60 |
| 96161 |
|
14 |
14 |
$70.00 |
| D0601 |
|
13 |
13 |
$0.13 |
| 90698 |
|
15 |
15 |
$0.00 |
| 90686 |
|
86 |
86 |
$0.00 |
| 90716 |
|
17 |
17 |
$0.00 |
| 90715 |
|
16 |
16 |
$0.00 |
| 3725F |
|
34 |
34 |
$0.00 |
| 90670 |
|
29 |
29 |
$0.00 |
| 96160 |
|
18 |
18 |
$0.00 |