| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
441 |
418 |
$23K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
212 |
205 |
$6K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
31 |
31 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
28 |
28 |
$3K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
26 |
26 |
$521.92 |
| 90619 |
|
19 |
19 |
$513.98 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
44 |
44 |
$273.47 |
| 92552 |
|
197 |
196 |
$224.72 |
| 87070 |
|
44 |
44 |
$205.59 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
102 |
98 |
$150.00 |
| 99173 |
|
205 |
203 |
$51.12 |
| 90461 |
|
45 |
45 |
$20.00 |
| 96127 |
|
53 |
53 |
$16.00 |
| 96160 |
|
75 |
75 |
$3.48 |
| 90700 |
|
32 |
32 |
$0.00 |
| 90713 |
|
16 |
16 |
$0.00 |
| 90707 |
|
12 |
12 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
57 |
56 |
$0.00 |