| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
995 |
954 |
$63K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
885 |
879 |
$53K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
661 |
657 |
$15K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
433 |
424 |
$7K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
153 |
148 |
$6K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
122 |
122 |
$5K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
51 |
51 |
$5K |
| 36416 |
|
19 |
12 |
$2K |
| 83655 |
|
14 |
14 |
$2K |
| 90670 |
|
247 |
245 |
$677.99 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
76 |
57 |
$588.00 |
| 90686 |
|
375 |
371 |
$188.47 |
| 90648 |
|
238 |
236 |
$131.50 |
| 90723 |
|
107 |
105 |
$0.00 |
| 90680 |
|
51 |
51 |
$0.00 |
| 90474 |
|
41 |
41 |
$0.00 |
| 90651 |
|
14 |
14 |
$0.00 |