| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
484 |
456 |
$40K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
196 |
181 |
$15K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
226 |
216 |
$13K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
43 |
43 |
$4K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
242 |
116 |
$3K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
224 |
223 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
108 |
105 |
$2K |
| 90670 |
|
125 |
125 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
12 |
12 |
$893.46 |
| 90686 |
|
65 |
65 |
$724.14 |
| 90698 |
|
64 |
64 |
$711.70 |
| 90680 |
|
49 |
49 |
$545.60 |
| 96161 |
|
46 |
41 |
$187.68 |
| 90744 |
|
13 |
13 |
$144.65 |
| 99000 |
|
79 |
77 |
$3.86 |