| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
421 |
352 |
$14K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
487 |
427 |
$12K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
241 |
165 |
$9K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
127 |
117 |
$5K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
91 |
80 |
$3K |
| 80305 |
|
262 |
218 |
$3K |
| 99442 |
|
105 |
101 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
483 |
423 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
29 |
27 |
$876.18 |
| 90461 |
|
252 |
211 |
$314.22 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
16 |
16 |
$169.58 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
27 |
24 |
$55.80 |
| G9903 |
Patient screened for tobacco use and identified as a tobacco non-user |
25 |
24 |
$55.80 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
19 |
14 |
$50.69 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
19 |
16 |
$30.30 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
22 |
22 |
$21.00 |
| 90686 |
|
18 |
18 |
$19.58 |
| 90670 |
|
72 |
56 |
$0.00 |
| 90734 |
|
18 |
12 |
$0.00 |
| 99441 |
|
64 |
64 |
$0.00 |
| 90688 |
|
18 |
15 |
$0.00 |
| 90698 |
|
15 |
15 |
$0.00 |
| 90651 |
|
19 |
12 |
$0.00 |