| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,350 |
1,231 |
$47K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
505 |
466 |
$25K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
282 |
282 |
$22K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
261 |
257 |
$20K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
173 |
171 |
$14K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,846 |
895 |
$14K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
476 |
348 |
$4K |
| 90461 |
|
529 |
408 |
$3K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
131 |
128 |
$2K |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
206 |
191 |
$1K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
84 |
81 |
$658.24 |
| 81002 |
|
194 |
189 |
$528.97 |
| A4327 |
Female external urinary collection device; meatal cup, each |
18 |
18 |
$378.00 |
| 99429 |
|
12 |
12 |
$375.76 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
26 |
13 |
$339.88 |
| 99000 |
|
194 |
189 |
$278.44 |
| 96160 |
|
220 |
136 |
$201.22 |
| 87807 |
|
14 |
12 |
$132.00 |
| 94760 |
|
416 |
371 |
$32.23 |
| 90686 |
|
162 |
159 |
$0.00 |
| 90744 |
|
13 |
12 |
$0.00 |
| 90688 |
|
31 |
31 |
$0.00 |
| 90698 |
|
27 |
27 |
$0.00 |
| 90680 |
|
24 |
24 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
19 |
18 |
$0.00 |
| 90670 |
|
205 |
203 |
$0.00 |
| 99072 |
|
2,674 |
2,342 |
$0.00 |
| 90710 |
|
24 |
24 |
$0.00 |
| 99173 |
|
57 |
56 |
$0.00 |
| 90700 |
|
43 |
43 |
$0.00 |
| 99051 |
|
148 |
141 |
$0.00 |
| 90633 |
|
12 |
12 |
$0.00 |
| 90713 |
|
13 |
13 |
$0.00 |