| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,345 |
3,472 |
$193K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,978 |
1,573 |
$63K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
780 |
441 |
$17K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
194 |
112 |
$9K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
105 |
70 |
$5K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
652 |
572 |
$5K |
| 3008F |
|
1,856 |
1,224 |
$4K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
53 |
39 |
$3K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
180 |
99 |
$3K |
| 99173 |
|
627 |
412 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
271 |
122 |
$2K |
| 90686 |
|
500 |
328 |
$1K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
130 |
92 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
17 |
13 |
$928.33 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
18 |
13 |
$829.61 |
| 96127 |
|
203 |
112 |
$664.39 |
| 87430 |
|
63 |
55 |
$382.49 |
| 36415 |
Collection of venous blood by venipuncture |
295 |
246 |
$339.49 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
69 |
52 |
$331.00 |
| 90461 |
|
148 |
96 |
$147.10 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
42 |
28 |
$115.31 |
| 81001 |
|
44 |
40 |
$58.16 |
| 90651 |
|
55 |
27 |
$0.01 |
| 99000 |
|
392 |
318 |
$0.00 |
| 90621 |
|
58 |
38 |
$0.00 |