| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,597 |
2,539 |
$131K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
655 |
655 |
$40K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,090 |
1,073 |
$39K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
599 |
592 |
$37K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
3,069 |
1,339 |
$26K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,078 |
1,070 |
$26K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,287 |
1,280 |
$17K |
| 99215 |
Prolong outpt/office vis |
179 |
178 |
$14K |
| 99429 |
|
311 |
311 |
$8K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
103 |
103 |
$8K |
| 90461 |
|
1,062 |
905 |
$6K |
| 99382 |
|
74 |
74 |
$5K |
| 87428 |
|
68 |
68 |
$5K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
543 |
486 |
$4K |
| 99383 |
|
44 |
44 |
$4K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
51 |
51 |
$4K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
58 |
58 |
$3K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
39 |
39 |
$3K |
| 99381 |
|
30 |
30 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
95 |
95 |
$1K |
| 87807 |
|
57 |
57 |
$605.00 |
| 90680 |
|
255 |
255 |
$0.00 |
| 90698 |
|
280 |
280 |
$0.00 |
| 90697 |
|
152 |
152 |
$0.00 |
| 90688 |
|
15 |
15 |
$0.00 |
| 90723 |
|
31 |
31 |
$0.00 |
| 90716 |
|
57 |
57 |
$0.00 |
| 90686 |
|
30 |
29 |
$0.00 |
| 96127 |
|
43 |
43 |
$0.00 |
| 90707 |
|
151 |
151 |
$0.00 |
| 90670 |
|
579 |
579 |
$0.00 |
| 90633 |
|
308 |
308 |
$0.00 |
| 90648 |
|
31 |
31 |
$0.00 |
| 90658 |
|
13 |
13 |
$0.00 |