| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,442 |
3,206 |
$249K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,553 |
1,529 |
$31K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
112 |
112 |
$10K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,617 |
1,617 |
$8K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
85 |
85 |
$7K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
58 |
58 |
$6K |
| 92552 |
|
424 |
423 |
$6K |
| 3008F |
|
454 |
454 |
$4K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
722 |
704 |
$4K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
42 |
39 |
$2K |
| 99051 |
|
288 |
274 |
$1K |
| 90686 |
|
66 |
66 |
$1K |
| 99173 |
|
576 |
576 |
$900.70 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
294 |
294 |
$40.00 |
| 99174 |
|
206 |
206 |
$9.00 |
| 97802 |
|
294 |
294 |
$0.00 |