| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,876 |
2,648 |
$173K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,071 |
1,032 |
$85K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,672 |
1,664 |
$66K |
| 87428 |
|
214 |
209 |
$14K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
246 |
244 |
$14K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
106 |
106 |
$7K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
111 |
100 |
$7K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
248 |
247 |
$6K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
134 |
129 |
$5K |
| 92551 |
|
710 |
710 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
58 |
58 |
$4K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
403 |
400 |
$2K |
| 87807 |
|
190 |
186 |
$2K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
55 |
54 |
$2K |
| 99173 |
|
259 |
259 |
$456.58 |
| 81000 |
|
103 |
103 |
$344.50 |
| 85018 |
|
12 |
12 |
$24.24 |
| 94760 |
|
162 |
147 |
$1.61 |
| 99000 |
|
15 |
15 |
$0.00 |