| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
8,411 |
7,527 |
$712K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,119 |
2,855 |
$419K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
5,035 |
4,730 |
$214K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,076 |
1,032 |
$130K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
739 |
704 |
$90K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
410 |
391 |
$45K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
2,566 |
2,444 |
$29K |
| 90670 |
|
304 |
282 |
$20K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
129 |
128 |
$18K |
| 90461 |
|
219 |
213 |
$12K |
| 90686 |
|
1,598 |
1,514 |
$10K |
| S0281 |
Medical home program, comprehensive care coordination and planning, maintenance of plan |
1,744 |
1,744 |
$7K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
241 |
234 |
$7K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
408 |
188 |
$7K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
352 |
318 |
$6K |
| 90734 |
|
47 |
47 |
$4K |
| 87428 |
|
64 |
57 |
$2K |
| 90723 |
|
41 |
39 |
$2K |
| 96127 |
|
173 |
172 |
$1K |
| 90651 |
|
12 |
12 |
$1K |
| 90715 |
|
31 |
31 |
$914.16 |
| 87430 |
|
64 |
64 |
$857.19 |
| 90633 |
|
56 |
54 |
$803.30 |
| 90647 |
|
66 |
65 |
$601.44 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
14 |
12 |
$118.56 |
| 36416 |
|
30 |
28 |
$0.00 |
| 90685 |
|
20 |
18 |
$0.00 |