| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,128 |
985 |
$46K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
542 |
251 |
$7K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
50 |
50 |
$4K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
479 |
202 |
$4K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
240 |
228 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
27 |
27 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
30 |
30 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
211 |
203 |
$2K |
| 99000 |
|
164 |
153 |
$1K |
| 92081 |
|
45 |
44 |
$867.30 |
| 90461 |
|
15 |
12 |
$93.62 |
| 92587 |
|
12 |
12 |
$68.48 |
| 36415 |
Collection of venous blood by venipuncture |
96 |
93 |
$0.00 |
| 90686 |
|
71 |
71 |
$0.00 |
| 96160 |
|
14 |
14 |
$0.00 |
| 99173 |
|
15 |
14 |
$0.00 |