| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
246 |
234 |
$20K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
137 |
135 |
$8K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
39 |
33 |
$3K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
126 |
62 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
95 |
91 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
156 |
129 |
$1K |
| 92551 |
|
128 |
111 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
18 |
13 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12 |
12 |
$979.32 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
157 |
140 |
$450.62 |
| 99174 |
|
51 |
45 |
$269.18 |
| 99173 |
|
102 |
86 |
$196.84 |
| 85014 |
|
46 |
42 |
$118.08 |
| 90461 |
|
51 |
48 |
$108.00 |
| 36416 |
|
97 |
91 |
$49.50 |
| 94760 |
|
38 |
35 |
$2.82 |
| 99000 |
|
31 |
30 |
$0.00 |