| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,444 |
1,222 |
$109K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
861 |
773 |
$40K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
142 |
112 |
$10K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
118 |
104 |
$9K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
76 |
64 |
$5K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
70 |
53 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
24 |
21 |
$704.25 |
| 92551 |
|
30 |
28 |
$457.52 |
| 96127 |
|
14 |
13 |
$204.40 |
| 81003 |
|
61 |
56 |
$109.00 |
| 99173 |
|
13 |
12 |
$96.85 |
| 3078F |
|
71 |
45 |
$0.00 |
| 3074F |
|
104 |
73 |
$0.00 |
| 3008F |
|
106 |
82 |
$0.00 |