| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
583 |
564 |
$29K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
658 |
639 |
$21K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
92 |
92 |
$9K |
| 99051 |
|
230 |
225 |
$5K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
41 |
41 |
$4K |
| 99072 |
|
79 |
76 |
$766.66 |
| 92551 |
|
240 |
236 |
$728.41 |
| 99173 |
|
174 |
172 |
$514.84 |
| 90688 |
|
84 |
78 |
$506.00 |
| 99188 |
|
24 |
24 |
$396.00 |
| 90687 |
|
33 |
26 |
$264.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
21 |
21 |
$142.24 |
| 90698 |
|
12 |
12 |
$132.00 |
| 90670 |
|
12 |
12 |
$132.00 |
| 96127 |
|
27 |
26 |
$30.80 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
25 |
25 |
$0.00 |
| 96160 |
|
13 |
12 |
$0.00 |