| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,352 |
1,321 |
$93K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,168 |
1,154 |
$52K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
298 |
297 |
$23K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
275 |
274 |
$21K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
73 |
73 |
$6K |
| 87428 |
|
79 |
79 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
28 |
28 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
80 |
79 |
$1K |
| 90686 |
|
214 |
210 |
$869.00 |
| 0071A |
|
12 |
12 |
$528.00 |
| 0072A |
|
14 |
14 |
$528.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
24 |
12 |
$258.58 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
92 |
92 |
$163.93 |
| 90670 |
|
13 |
13 |
$143.00 |
| 90648 |
|
12 |
12 |
$132.00 |
| 96127 |
|
60 |
60 |
$36.96 |
| 96160 |
|
60 |
60 |
$32.16 |
| 92551 |
|
123 |
122 |
$30.54 |
| 99177 |
|
43 |
43 |
$26.43 |
| G9920 |
Screening performed and negative |
255 |
254 |
$0.00 |
| 99173 |
|
27 |
26 |
$0.00 |
| 90661 |
|
26 |
26 |
$0.00 |
| 96161 |
|
25 |
25 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
28 |
28 |
$0.00 |
| 90656 |
|
26 |
26 |
$0.00 |