| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,422 |
2,280 |
$126K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,780 |
2,428 |
$107K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
4,219 |
2,763 |
$42K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
830 |
635 |
$33K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
943 |
619 |
$27K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,839 |
1,986 |
$26K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
810 |
509 |
$25K |
| 92552 |
|
2,142 |
1,433 |
$25K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,380 |
916 |
$19K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
598 |
391 |
$17K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
742 |
597 |
$14K |
| 99173 |
|
1,181 |
789 |
$8K |
| 90686 |
|
1,554 |
963 |
$7K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
277 |
224 |
$7K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
264 |
231 |
$4K |
| 90670 |
|
573 |
348 |
$3K |
| 90648 |
|
131 |
102 |
$2K |
| 96161 |
|
304 |
191 |
$2K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
141 |
105 |
$2K |
| 90723 |
|
341 |
206 |
$1K |
| 81002 |
|
142 |
88 |
$1K |
| 90633 |
|
168 |
106 |
$1K |
| 90656 |
|
97 |
85 |
$1K |
| 90473 |
|
161 |
100 |
$1K |
| 69210 |
|
32 |
27 |
$1K |
| 90680 |
|
328 |
194 |
$960.44 |
| 90647 |
|
374 |
208 |
$272.24 |
| 90734 |
|
231 |
109 |
$250.90 |
| 90651 |
|
187 |
83 |
$195.67 |
| 96160 |
|
180 |
87 |
$55.88 |
| 81025 |
|
31 |
14 |
$13.95 |
| 90715 |
|
62 |
31 |
$12.89 |
| 99384 |
|
40 |
18 |
$0.00 |
| 90620 |
|
38 |
13 |
$0.00 |
| 90700 |
|
18 |
13 |
$0.00 |