| Code | Description | Claims | Beneficiaries | Total Paid |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,419 |
2,796 |
$246K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,957 |
3,283 |
$185K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,621 |
1,347 |
$14K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
115 |
99 |
$9K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
500 |
423 |
$8K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
98 |
80 |
$6K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
501 |
407 |
$6K |
| 99215 |
Prolong outpt/office vis |
26 |
24 |
$4K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
197 |
121 |
$4K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
30 |
25 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
27 |
27 |
$2K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
29 |
27 |
$1K |
| 96127 |
|
201 |
176 |
$596.48 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
15 |
15 |
$476.41 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
22 |
13 |
$108.25 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
14 |
12 |
$28.34 |
| 96160 |
|
18 |
17 |
$16.94 |
| 99051 |
|
265 |
196 |
$1.28 |
| 90686 |
|
475 |
367 |
$0.00 |
| 90670 |
|
24 |
24 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
19 |
13 |
$0.00 |
| 99072 |
|
49 |
48 |
$0.00 |