| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,291 |
1,127 |
$87K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
622 |
568 |
$28K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
522 |
489 |
$16K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
118 |
113 |
$9K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
113 |
107 |
$8K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
121 |
108 |
$8K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
32 |
29 |
$2K |
| 99215 |
Prolong outpt/office vis |
18 |
18 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
214 |
135 |
$2K |
| 92551 |
|
471 |
430 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
18 |
17 |
$436.90 |
| 96160 |
|
147 |
134 |
$366.30 |
| 99173 |
|
326 |
296 |
$88.82 |
| 94760 |
|
718 |
580 |
$49.65 |
| 99000 |
|
109 |
66 |
$41.04 |
| 90686 |
|
68 |
57 |
$0.00 |
| 90734 |
|
13 |
12 |
$0.00 |