| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,151 |
1,100 |
$60K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
976 |
913 |
$36K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,287 |
589 |
$12K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
122 |
111 |
$9K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
71 |
71 |
$6K |
| 87428 |
|
75 |
74 |
$5K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
325 |
315 |
$4K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
139 |
130 |
$4K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
29 |
29 |
$3K |
| S8301 |
Infection control supplies, not otherwise specified |
273 |
262 |
$3K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
113 |
56 |
$2K |
| 90461 |
|
249 |
213 |
$1K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
67 |
66 |
$980.06 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
13 |
13 |
$946.53 |
| 92551 |
|
165 |
163 |
$179.37 |
| 87807 |
|
12 |
12 |
$116.60 |
| 90686 |
|
133 |
132 |
$0.01 |
| 90670 |
|
39 |
39 |
$0.00 |