| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,664 |
3,312 |
$216K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,220 |
2,065 |
$193K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,441 |
1,418 |
$49K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
412 |
403 |
$33K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
212 |
212 |
$19K |
| 90461 |
|
508 |
507 |
$17K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
641 |
626 |
$7K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
56 |
56 |
$5K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
500 |
498 |
$4K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
254 |
124 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
116 |
116 |
$2K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
47 |
41 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
17 |
17 |
$2K |
| 90686 |
|
77 |
77 |
$785.17 |
| 92587 |
|
41 |
41 |
$750.47 |
| 90734 |
|
18 |
18 |
$677.58 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
36 |
36 |
$666.43 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
24 |
24 |
$328.38 |
| 99174 |
|
56 |
56 |
$81.60 |
| 96127 |
|
16 |
16 |
$62.50 |
| 96161 |
|
12 |
12 |
$39.87 |
| 36416 |
|
56 |
56 |
$11.48 |
| 99072 |
|
61 |
53 |
$0.00 |
| 99000 |
|
64 |
56 |
$0.00 |