| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
274 |
233 |
$14K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
79 |
63 |
$6K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
58 |
47 |
$3K |
| 90670 |
|
50 |
40 |
$1K |
| 99383 |
|
14 |
12 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12 |
12 |
$927.60 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
24 |
24 |
$822.87 |
| 0071A |
|
24 |
18 |
$720.00 |
| 90698 |
|
35 |
26 |
$575.04 |
| 90686 |
|
22 |
16 |
$183.13 |
| 99173 |
|
62 |
58 |
$143.27 |
| 99177 |
|
13 |
13 |
$44.28 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
167 |
137 |
$34.00 |
| 90461 |
|
69 |
55 |
$20.40 |
| 91307 |
|
27 |
18 |
$0.19 |