| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,817 |
1,577 |
$134K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,335 |
1,065 |
$91K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,549 |
1,409 |
$76K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
883 |
812 |
$67K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
333 |
306 |
$24K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
293 |
257 |
$24K |
| 96127 |
|
696 |
539 |
$9K |
| 90670 |
|
466 |
409 |
$5K |
| 90686 |
|
280 |
243 |
$3K |
| 90647 |
|
164 |
151 |
$1K |
| 90723 |
|
143 |
126 |
$1K |
| 83655 |
|
85 |
82 |
$1K |
| 90680 |
|
106 |
95 |
$834.29 |
| 90656 |
|
36 |
28 |
$601.56 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
36 |
30 |
$549.50 |
| 90734 |
|
59 |
53 |
$510.59 |
| 90671 |
|
16 |
14 |
$303.16 |
| 90681 |
|
16 |
12 |
$267.36 |
| 90633 |
|
25 |
25 |
$249.69 |
| 90698 |
|
16 |
15 |
$192.14 |
| 90651 |
|
25 |
25 |
$160.00 |
| 85018 |
|
54 |
54 |
$125.28 |
| 90715 |
|
12 |
12 |
$108.85 |
| 99173 |
|
17 |
13 |
$102.00 |
| 90461 |
|
59 |
42 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
143 |
110 |
$0.00 |