| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,245 |
1,136 |
$83K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,047 |
1,985 |
$74K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,567 |
1,488 |
$73K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
795 |
716 |
$53K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
448 |
417 |
$30K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
429 |
416 |
$30K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
200 |
192 |
$15K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
357 |
222 |
$4K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
208 |
199 |
$3K |
| 0002A |
|
42 |
42 |
$2K |
| 0001A |
|
32 |
32 |
$2K |
| 92551 |
|
511 |
489 |
$1K |
| 96161 |
|
255 |
242 |
$780.86 |
| 99460 |
|
12 |
12 |
$755.93 |
| 96160 |
|
169 |
157 |
$541.41 |
| 0011A |
|
12 |
12 |
$480.00 |
| 69210 |
|
13 |
13 |
$439.31 |
| 99173 |
|
532 |
506 |
$248.50 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
17 |
12 |
$174.48 |
| 83655 |
|
41 |
27 |
$168.91 |
| 85018 |
|
104 |
84 |
$119.83 |
| 96127 |
|
105 |
99 |
$40.81 |
| 81002 |
|
14 |
14 |
$35.41 |
| 94760 |
|
458 |
403 |
$33.28 |
| 91301 |
|
14 |
14 |
$0.05 |
| 90686 |
|
399 |
361 |
$0.00 |
| 90680 |
|
162 |
153 |
$0.00 |
| 90716 |
|
28 |
25 |
$0.00 |
| 90651 |
|
96 |
85 |
$0.00 |
| 36416 |
|
28 |
28 |
$0.00 |
| 90744 |
|
13 |
12 |
$0.00 |
| 90688 |
|
17 |
13 |
$0.00 |
| 90700 |
|
409 |
386 |
$0.00 |
| 90713 |
|
307 |
291 |
$0.00 |
| 91300 |
|
82 |
79 |
$0.00 |
| 90670 |
|
332 |
305 |
$0.00 |
| 90648 |
|
304 |
285 |
$0.00 |
| 90707 |
|
28 |
25 |
$0.00 |
| 90633 |
|
31 |
25 |
$0.00 |
| 90734 |
|
13 |
12 |
$0.00 |