| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
609 |
595 |
$19K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
388 |
374 |
$18K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
80 |
80 |
$7K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
24 |
24 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
12 |
12 |
$990.50 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
19 |
19 |
$702.72 |
| 90688 |
|
74 |
70 |
$256.00 |
| 96160 |
|
52 |
52 |
$33.57 |
| 96127 |
|
26 |
26 |
$22.00 |
| 99173 |
|
12 |
12 |
$1.00 |
| 1111F |
|
1,117 |
1,095 |
$0.00 |
| 3074F |
|
1,145 |
1,122 |
$0.00 |
| 3008F |
|
352 |
349 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
13 |
13 |
$0.00 |
| 90686 |
|
12 |
12 |
$0.00 |
| 92551 |
|
15 |
15 |
$0.00 |
| 3078F |
|
1,080 |
1,057 |
$0.00 |
| 90658 |
|
12 |
12 |
$0.00 |