| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,484 |
3,107 |
$227K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
549 |
526 |
$45K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,765 |
1,651 |
$38K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
405 |
391 |
$37K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
280 |
270 |
$25K |
| 90461 |
|
688 |
614 |
$21K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
213 |
191 |
$17K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
80 |
80 |
$9K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
332 |
187 |
$4K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
99 |
97 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
160 |
154 |
$2K |
| 99050 |
|
36 |
36 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
87 |
87 |
$914.58 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
79 |
58 |
$873.00 |
| 87428 |
|
15 |
15 |
$832.05 |
| 92587 |
|
12 |
12 |
$660.74 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
14 |
12 |
$460.58 |
| 87807 |
|
50 |
48 |
$457.30 |
| 96127 |
|
123 |
118 |
$390.45 |
| 96161 |
|
69 |
64 |
$253.24 |
| 99177 |
|
55 |
52 |
$251.46 |
| 96160 |
|
85 |
85 |
$236.68 |
| 92552 |
|
12 |
12 |
$192.75 |
| 87070 |
|
25 |
25 |
$156.22 |
| 90686 |
|
150 |
144 |
$72.50 |
| 99173 |
|
12 |
12 |
$22.44 |
| 90672 |
|
15 |
15 |
$7.50 |