| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,161 |
980 |
$61K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
971 |
849 |
$35K |
| 96127 |
|
749 |
597 |
$19K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
330 |
273 |
$13K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
234 |
196 |
$8K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
112 |
88 |
$7K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
459 |
356 |
$2K |
| 92551 |
|
185 |
155 |
$2K |
| 87428 |
|
25 |
24 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
16 |
12 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
14 |
14 |
$1K |
| 99177 |
|
357 |
287 |
$985.56 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
152 |
69 |
$882.64 |
| 92588 |
|
12 |
12 |
$236.64 |
| 92558 |
|
69 |
63 |
$208.80 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
13 |
12 |
$129.35 |
| 3008F |
|
123 |
103 |
$0.00 |
| 97802 |
|
17 |
12 |
$0.00 |
| 90686 |
|
75 |
67 |
$0.00 |
| 99000 |
|
55 |
45 |
$0.00 |
| 36416 |
|
18 |
12 |
$0.00 |