| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
275 |
258 |
$23K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
214 |
201 |
$12K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
45 |
42 |
$3K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
29 |
26 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
23 |
22 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
224 |
170 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
101 |
50 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
92 |
91 |
$1K |
| 92551 |
|
116 |
108 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
13 |
13 |
$978.68 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
178 |
159 |
$604.93 |
| 99174 |
|
60 |
57 |
$341.04 |
| 90461 |
|
87 |
83 |
$305.90 |
| 83655 |
|
15 |
13 |
$190.71 |
| 99173 |
|
78 |
71 |
$163.17 |
| 85014 |
|
22 |
20 |
$54.72 |
| 36416 |
|
22 |
20 |
$12.10 |
| 99000 |
|
92 |
89 |
$11.58 |
| 94760 |
|
60 |
53 |
$0.00 |