| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
370 |
360 |
$19K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
111 |
111 |
$8K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
101 |
99 |
$8K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
203 |
194 |
$7K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
472 |
193 |
$6K |
| 87428 |
|
148 |
143 |
$4K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
211 |
205 |
$3K |
| 99429 |
|
105 |
104 |
$3K |
| 90677 |
|
110 |
105 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
111 |
80 |
$866.32 |
| 87807 |
|
46 |
44 |
$484.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
15 |
15 |
$194.60 |
| 90461 |
|
190 |
161 |
$33.24 |
| 90697 |
|
37 |
32 |
$0.00 |
| 90698 |
|
30 |
30 |
$0.00 |
| 90681 |
|
33 |
29 |
$0.00 |
| 90633 |
|
27 |
27 |
$0.00 |