| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,467 |
1,296 |
$94K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,934 |
1,700 |
$92K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,564 |
1,417 |
$29K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
401 |
394 |
$18K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
328 |
327 |
$14K |
| 90461 |
|
556 |
520 |
$8K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
128 |
128 |
$6K |
| 92551 |
|
420 |
420 |
$5K |
| 90670 |
|
193 |
193 |
$4K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
178 |
169 |
$2K |
| 99215 |
Prolong outpt/office vis |
13 |
13 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
31 |
31 |
$852.50 |
| 90698 |
|
83 |
83 |
$739.04 |
| 90686 |
|
34 |
34 |
$604.23 |
| 90680 |
|
29 |
29 |
$82.89 |
| 94760 |
|
407 |
382 |
$0.00 |
| 99173 |
|
19 |
19 |
$0.00 |
| 99051 |
|
51 |
48 |
$0.00 |
| 90648 |
|
25 |
25 |
$0.00 |