| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
323 |
317 |
$22K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
121 |
115 |
$13K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
267 |
266 |
$12K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
89 |
86 |
$8K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
69 |
63 |
$3K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
27 |
27 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
13 |
13 |
$1K |
| 90473 |
|
26 |
26 |
$476.84 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
13 |
13 |
$108.03 |
| 90698 |
|
24 |
24 |
$0.00 |
| 90680 |
|
12 |
12 |
$0.00 |
| 90686 |
|
70 |
70 |
$0.00 |
| 90670 |
|
57 |
57 |
$0.00 |
| 90672 |
|
40 |
40 |
$0.00 |