| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,570 |
1,392 |
$95K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
347 |
303 |
$24K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
451 |
440 |
$10K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
38 |
36 |
$3K |
| 90461 |
|
60 |
60 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
13 |
13 |
$1K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
17 |
17 |
$427.47 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
33 |
33 |
$421.44 |
| 90686 |
|
556 |
295 |
$288.50 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
14 |
12 |
$103.13 |
| 99173 |
|
41 |
41 |
$88.76 |