| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
237 |
222 |
$19K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
253 |
241 |
$14K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
47 |
39 |
$3K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
88 |
44 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
159 |
117 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12 |
12 |
$979.32 |
| 92551 |
|
101 |
89 |
$941.94 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
152 |
135 |
$696.54 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
36 |
36 |
$509.25 |
| 90461 |
|
71 |
64 |
$406.04 |
| 99173 |
|
63 |
52 |
$121.73 |
| 99174 |
|
24 |
16 |
$82.70 |
| 85014 |
|
16 |
14 |
$40.32 |
| 36416 |
|
64 |
54 |
$27.50 |
| 94760 |
|
65 |
65 |
$0.00 |