| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,329 |
1,143 |
$93K |
| 99215 |
Prolong outpt/office vis |
614 |
521 |
$60K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
697 |
609 |
$35K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
731 |
651 |
$16K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
76 |
74 |
$5K |
| 90461 |
|
225 |
190 |
$5K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
60 |
60 |
$4K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
493 |
452 |
$3K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
36 |
36 |
$2K |
| 96160 |
|
327 |
291 |
$570.03 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
27 |
26 |
$329.72 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
26 |
26 |
$327.88 |
| 99173 |
|
64 |
59 |
$113.29 |
| 99177 |
|
12 |
12 |
$35.64 |
| 90670 |
|
15 |
14 |
$0.00 |
| 90672 |
|
12 |
12 |
$0.00 |
| 90686 |
|
77 |
73 |
$0.00 |
| 90656 |
|
12 |
12 |
$0.00 |