| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,633 |
1,396 |
$117K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
396 |
227 |
$32K |
| 96160 |
|
850 |
480 |
$16K |
| 96127 |
|
777 |
448 |
$11K |
| 90686 |
|
490 |
390 |
$6K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
71 |
59 |
$5K |
| 90656 |
|
215 |
140 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
146 |
140 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
26 |
24 |
$417.95 |
| 99000 |
|
16 |
13 |
$375.36 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
17 |
14 |
$153.34 |
| 90651 |
|
12 |
12 |
$76.80 |
| 3725F |
|
262 |
188 |
$0.00 |
| 1033F |
|
205 |
61 |
$0.00 |
| 3085F |
|
262 |
188 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,201 |
810 |
$0.00 |
| 4274F |
|
58 |
49 |
$0.00 |
| 97802 |
|
119 |
101 |
$0.00 |
| 3008F |
|
584 |
201 |
$0.00 |
| 1036F |
|
37 |
24 |
$0.00 |
| 1038F |
|
20 |
14 |
$0.00 |