| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
766 |
748 |
$51K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
718 |
709 |
$32K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
67 |
67 |
$6K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
54 |
54 |
$5K |
| 90686 |
|
122 |
113 |
$672.68 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
50 |
24 |
$562.40 |
| 99051 |
|
14 |
14 |
$437.24 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
32 |
30 |
$401.72 |
| 87428 |
|
12 |
12 |
$238.30 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
17 |
17 |
$170.00 |
| G9920 |
Screening performed and negative |
59 |
59 |
$0.00 |
| 99177 |
|
44 |
44 |
$0.00 |
| 92551 |
|
69 |
69 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
13 |
13 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
13 |
13 |
$0.00 |