| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
309 |
288 |
$25K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
197 |
184 |
$11K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
23 |
21 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
111 |
55 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
16 |
15 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
86 |
85 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
173 |
115 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
13 |
13 |
$1K |
| 92551 |
|
103 |
93 |
$994.22 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
140 |
126 |
$405.24 |
| 99173 |
|
67 |
59 |
$134.68 |
| 90461 |
|
35 |
27 |
$102.80 |
| 85014 |
|
25 |
17 |
$48.96 |
| 36416 |
|
62 |
54 |
$28.60 |
| 94760 |
|
48 |
47 |
$2.82 |
| 99000 |
|
56 |
54 |
$0.00 |