| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
355 |
310 |
$13K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
137 |
128 |
$9K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
731 |
337 |
$9K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
83 |
80 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
44 |
43 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
28 |
27 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
67 |
66 |
$917.40 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
63 |
58 |
$849.61 |
| 99383 |
|
12 |
12 |
$683.34 |
| 87807 |
|
47 |
46 |
$517.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
48 |
47 |
$377.61 |
| 90677 |
|
103 |
101 |
$272.30 |
| 92558 |
|
73 |
73 |
$213.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
14 |
14 |
$159.24 |
| 90461 |
|
439 |
99 |
$16.80 |
| 90686 |
|
62 |
62 |
$0.00 |
| 90680 |
|
44 |
43 |
$0.00 |
| 90698 |
|
103 |
101 |
$0.00 |
| 99177 |
|
148 |
145 |
$0.00 |
| 90633 |
|
12 |
12 |
$0.00 |
| 99173 |
|
36 |
36 |
$0.00 |