| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,514 |
2,369 |
$194K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,268 |
2,165 |
$112K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
526 |
525 |
$42K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
469 |
464 |
$42K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
227 |
227 |
$19K |
| 99051 |
|
628 |
622 |
$18K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
472 |
462 |
$7K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
68 |
68 |
$6K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
350 |
173 |
$4K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
107 |
105 |
$4K |
| 87428 |
|
87 |
87 |
$3K |
| 90648 |
|
238 |
232 |
$586.00 |
| 90670 |
|
174 |
168 |
$572.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
12 |
12 |
$379.50 |
| 90680 |
|
27 |
27 |
$180.00 |
| 90723 |
|
57 |
57 |
$176.00 |
| 96127 |
|
184 |
184 |
$118.80 |
| 92551 |
|
204 |
204 |
$110.40 |
| 96160 |
|
183 |
183 |
$103.39 |
| 99177 |
|
143 |
143 |
$94.86 |
| 90686 |
|
101 |
101 |
$55.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
135 |
135 |
$43.12 |
| 85018 |
|
14 |
14 |
$7.44 |
| 96161 |
|
164 |
164 |
$0.00 |
| 90677 |
|
61 |
61 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
13 |
13 |
$0.00 |
| G9920 |
Screening performed and negative |
164 |
163 |
$0.00 |
| 90633 |
|
13 |
13 |
$0.00 |