| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
980 |
895 |
$69K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,338 |
796 |
$44K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,977 |
1,151 |
$40K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
836 |
800 |
$40K |
| 96160 |
|
1,328 |
591 |
$15K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
198 |
160 |
$14K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
153 |
99 |
$10K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
128 |
119 |
$9K |
| 92551 |
|
595 |
461 |
$4K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
55 |
38 |
$4K |
| 99177 |
|
625 |
520 |
$4K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
113 |
77 |
$3K |
| 99173 |
|
406 |
302 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
201 |
188 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
172 |
84 |
$2K |
| 90461 |
|
550 |
386 |
$313.02 |
| 90670 |
|
161 |
152 |
$239.82 |
| 90688 |
|
107 |
71 |
$145.95 |
| 90686 |
|
142 |
123 |
$0.00 |
| 90698 |
|
71 |
68 |
$0.00 |
| 90680 |
|
12 |
12 |
$0.00 |
| 90685 |
|
40 |
38 |
$0.00 |