| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,470 |
4,713 |
$236K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
674 |
660 |
$46K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
403 |
395 |
$31K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
450 |
440 |
$28K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,915 |
838 |
$20K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
249 |
240 |
$18K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
560 |
532 |
$17K |
| 99384 |
|
143 |
142 |
$12K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,573 |
1,534 |
$11K |
| 99383 |
|
91 |
90 |
$7K |
| 90461 |
|
664 |
370 |
$3K |
| 99000 |
|
174 |
170 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
24 |
24 |
$1K |
| 99382 |
|
12 |
12 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
34 |
30 |
$411.09 |
| 90658 |
|
28 |
27 |
$101.83 |
| 90696 |
|
25 |
25 |
$0.00 |
| 86580 |
|
13 |
13 |
$0.00 |
| 90670 |
|
81 |
80 |
$0.00 |
| 90633 |
|
31 |
31 |
$0.00 |
| 90710 |
|
54 |
54 |
$0.00 |
| 90715 |
|
14 |
14 |
$0.00 |