| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,293 |
3,887 |
$337K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,352 |
3,955 |
$220K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,385 |
1,382 |
$128K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,256 |
1,254 |
$122K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
944 |
939 |
$86K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
630 |
630 |
$62K |
| 99188 |
|
1,236 |
1,236 |
$24K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
777 |
745 |
$12K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
266 |
262 |
$10K |
| 87428 |
|
143 |
137 |
$5K |
| 90686 |
|
938 |
926 |
$4K |
| 92551 |
|
2,477 |
2,474 |
$4K |
| 99173 |
|
1,798 |
1,796 |
$3K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
151 |
76 |
$2K |
| 90648 |
|
611 |
605 |
$2K |
| 90670 |
|
448 |
442 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
35 |
35 |
$926.19 |
| 0071A |
|
20 |
20 |
$704.00 |
| 90680 |
|
284 |
283 |
$522.13 |
| 90723 |
|
332 |
331 |
$429.00 |
| 90716 |
|
108 |
107 |
$385.00 |
| 99177 |
|
1,181 |
1,179 |
$375.66 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,576 |
1,574 |
$333.29 |
| 96127 |
|
865 |
865 |
$320.32 |
| 96160 |
|
865 |
865 |
$278.72 |
| 90707 |
|
81 |
81 |
$275.00 |
| 90633 |
|
118 |
118 |
$165.00 |
| 0072A |
|
15 |
15 |
$88.00 |
| 81002 |
|
14 |
13 |
$51.17 |
| 80061 |
Lipid panel |
54 |
54 |
$48.42 |
| 83655 |
|
86 |
86 |
$0.00 |
| G9920 |
Screening performed and negative |
874 |
871 |
$0.00 |
| 90661 |
|
153 |
153 |
$0.00 |
| 90715 |
|
12 |
12 |
$0.00 |
| 96161 |
|
742 |
740 |
$0.00 |
| 90677 |
|
149 |
149 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
322 |
315 |
$0.00 |
| 90620 |
|
38 |
38 |
$0.00 |
| 90651 |
|
114 |
114 |
$0.00 |
| 90619 |
|
39 |
39 |
$0.00 |
| 85018 |
|
12 |
12 |
$0.00 |