| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
235 |
215 |
$20K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
319 |
305 |
$19K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
91 |
88 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
13 |
13 |
$1K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
13 |
12 |
$916.80 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
35 |
33 |
$899.59 |
| 90686 |
|
49 |
48 |
$567.35 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
124 |
117 |
$158.76 |
| 92551 |
|
12 |
12 |
$129.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
12 |
12 |
$105.60 |
| 90461 |
|
41 |
36 |
$66.80 |