| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,175 |
1,123 |
$55K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
244 |
244 |
$13K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
249 |
246 |
$12K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,157 |
506 |
$11K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
260 |
254 |
$9K |
| 99215 |
Prolong outpt/office vis |
120 |
116 |
$9K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
522 |
508 |
$7K |
| 87428 |
|
99 |
98 |
$7K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
302 |
302 |
$6K |
| 99429 |
|
244 |
242 |
$5K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
61 |
61 |
$4K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
37 |
37 |
$3K |
| 90461 |
|
489 |
397 |
$3K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
259 |
220 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
27 |
27 |
$2K |
| 87807 |
|
77 |
76 |
$825.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
50 |
50 |
$639.40 |
| 90696 |
|
38 |
38 |
$0.00 |
| 90698 |
|
108 |
108 |
$0.00 |
| 90697 |
|
99 |
99 |
$0.00 |
| 90680 |
|
99 |
98 |
$0.00 |
| 96127 |
|
39 |
38 |
$0.00 |
| 90686 |
|
17 |
17 |
$0.00 |
| 90670 |
|
252 |
251 |
$0.00 |
| 90633 |
|
115 |
115 |
$0.00 |
| 90707 |
|
81 |
81 |
$0.00 |
| 90710 |
|
18 |
18 |
$0.00 |