| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
445 |
413 |
$36K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
365 |
341 |
$19K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
124 |
108 |
$9K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
64 |
57 |
$4K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
62 |
53 |
$4K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
54 |
46 |
$4K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
249 |
117 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
192 |
179 |
$3K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
355 |
251 |
$2K |
| 92551 |
|
222 |
194 |
$2K |
| 83655 |
|
124 |
101 |
$1K |
| 90670 |
|
49 |
40 |
$1K |
| 90651 |
|
39 |
31 |
$1K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
312 |
264 |
$893.98 |
| 99174 |
|
92 |
78 |
$429.40 |
| 90461 |
|
185 |
157 |
$408.50 |
| 85014 |
|
163 |
132 |
$365.76 |
| 99173 |
|
188 |
159 |
$362.60 |
| 90698 |
|
15 |
12 |
$295.90 |
| 90734 |
|
19 |
14 |
$273.69 |
| 90688 |
|
20 |
17 |
$197.51 |
| 90715 |
|
16 |
13 |
$170.19 |
| 90633 |
|
18 |
12 |
$157.93 |
| 36416 |
|
183 |
149 |
$73.70 |
| 94760 |
|
193 |
181 |
$16.92 |
| 99000 |
|
104 |
96 |
$7.72 |