| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
133 |
117 |
$14K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
48 |
47 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
32 |
32 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
30 |
30 |
$709.56 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
27 |
27 |
$486.00 |
| 92551 |
|
42 |
42 |
$259.60 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
19 |
17 |
$183.20 |
| 99173 |
|
21 |
21 |
$159.60 |
| 36416 |
|
47 |
47 |
$156.15 |
| 81000 |
|
49 |
49 |
$141.94 |
| 85018 |
|
47 |
47 |
$2.26 |