| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,814 |
1,489 |
$103K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,904 |
1,587 |
$76K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
756 |
710 |
$13K |
| 99401 |
|
459 |
439 |
$6K |
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
18 |
18 |
$5K |
| 92551 |
|
458 |
457 |
$5K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
190 |
176 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
53 |
51 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
51 |
51 |
$3K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
13 |
13 |
$820.77 |
| 90686 |
|
100 |
92 |
$712.96 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
19 |
17 |
$692.89 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12 |
12 |
$634.92 |
| 99173 |
|
448 |
433 |
$610.87 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
52 |
50 |
$584.67 |
| 90461 |
|
58 |
57 |
$555.68 |
| 99188 |
|
28 |
28 |
$550.00 |
| 92587 |
|
55 |
37 |
$359.92 |
| 92558 |
|
51 |
48 |
$205.70 |
| 96127 |
|
40 |
37 |
$89.48 |
| 90658 |
|
34 |
34 |
$43.23 |
| 90657 |
|
45 |
45 |
$41.11 |
| S9451 |
Exercise classes, non-physician provider, per session |
14 |
14 |
$36.00 |
| 3008F |
|
14 |
14 |
$30.00 |
| 99051 |
|
16 |
16 |
$20.00 |
| 97803 |
|
19 |
19 |
$17.55 |
| 97802 |
|
23 |
23 |
$0.00 |
| 90688 |
|
19 |
17 |
$0.00 |