| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
578 |
548 |
$39K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
917 |
888 |
$36K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
515 |
462 |
$34K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
685 |
653 |
$32K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
124 |
119 |
$9K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
85 |
53 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
14 |
14 |
$995.40 |
| 92551 |
|
100 |
92 |
$335.07 |
| 96161 |
|
56 |
55 |
$189.62 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
13 |
13 |
$176.38 |
| 99173 |
|
103 |
96 |
$61.93 |
| 96160 |
|
18 |
15 |
$54.48 |
| 94760 |
|
118 |
111 |
$5.17 |
| 90700 |
|
212 |
190 |
$0.00 |
| 90648 |
|
196 |
169 |
$0.00 |
| 90670 |
|
218 |
187 |
$0.00 |
| 90713 |
|
113 |
95 |
$0.00 |
| 90686 |
|
104 |
96 |
$0.00 |
| 90680 |
|
26 |
25 |
$0.00 |