| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,373 |
1,171 |
$110K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
285 |
239 |
$13K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
483 |
431 |
$7K |
| 92552 |
|
311 |
305 |
$5K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
56 |
50 |
$4K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
43 |
43 |
$3K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
13 |
13 |
$814.97 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
59 |
39 |
$710.22 |
| 99000 |
|
124 |
118 |
$630.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
53 |
52 |
$373.24 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
24 |
24 |
$316.07 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
27 |
23 |
$244.48 |
| 97802 |
|
29 |
27 |
$92.89 |
| 96127 |
|
16 |
12 |
$73.11 |
| 90686 |
|
59 |
59 |
$58.19 |
| 90461 |
|
40 |
33 |
$0.00 |
| 99173 |
|
76 |
73 |
$0.00 |
| 99401 |
|
78 |
69 |
$0.00 |
| 99072 |
|
18 |
17 |
$0.00 |