| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,024 |
1,662 |
$100K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,336 |
1,037 |
$43K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
552 |
459 |
$33K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
643 |
440 |
$31K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,425 |
923 |
$26K |
| 90677 |
|
301 |
250 |
$22K |
| 87428 |
|
278 |
255 |
$8K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
105 |
101 |
$8K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
588 |
536 |
$7K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
112 |
97 |
$5K |
| 99382 |
|
34 |
28 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
382 |
234 |
$2K |
| 99383 |
|
25 |
25 |
$2K |
| 99381 |
|
25 |
18 |
$1K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
12 |
12 |
$1K |
| 92551 |
|
245 |
194 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
72 |
34 |
$946.60 |
| 87807 |
|
67 |
62 |
$683.10 |
| 90461 |
|
857 |
628 |
$482.27 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
51 |
44 |
$154.10 |
| 83655 |
|
19 |
14 |
$142.89 |
| 85018 |
|
46 |
39 |
$61.69 |
| 99177 |
|
44 |
36 |
$14.00 |
| 90698 |
|
326 |
252 |
$0.00 |
| 90680 |
|
242 |
182 |
$0.00 |
| 90656 |
|
46 |
44 |
$0.00 |
| 96127 |
|
165 |
133 |
$0.00 |
| 90744 |
|
109 |
85 |
$0.00 |
| 99174 |
|
158 |
146 |
$0.00 |
| 90686 |
|
117 |
111 |
$0.00 |
| 90716 |
|
31 |
25 |
$0.00 |
| 90670 |
|
114 |
83 |
$0.00 |
| 99173 |
|
51 |
45 |
$0.00 |
| 90707 |
|
66 |
43 |
$0.00 |
| 90710 |
|
17 |
12 |
$0.00 |
| 90633 |
|
126 |
102 |
$0.00 |