| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,512 |
3,194 |
$353K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
558 |
533 |
$37K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
252 |
252 |
$10K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
107 |
100 |
$5K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
178 |
170 |
$5K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
79 |
79 |
$3K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
26 |
26 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
174 |
169 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
27 |
27 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
21 |
21 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
158 |
158 |
$1K |
| 36415 |
Collection of venous blood by venipuncture |
329 |
321 |
$1K |
| 96127 |
|
210 |
210 |
$988.91 |
| 99173 |
|
170 |
170 |
$420.36 |
| 99408 |
|
12 |
12 |
$360.72 |
| 90686 |
|
19 |
19 |
$0.01 |
| 96160 |
|
172 |
172 |
$0.00 |
| 90734 |
|
14 |
14 |
$0.00 |
| 90715 |
|
15 |
15 |
$0.00 |
| 90651 |
|
14 |
14 |
$0.00 |