| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,508 |
1,455 |
$65K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
348 |
338 |
$26K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
123 |
123 |
$12K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
111 |
111 |
$8K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
40 |
40 |
$4K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
32 |
32 |
$3K |
| 87428 |
|
50 |
49 |
$2K |
| 90686 |
|
164 |
150 |
$715.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
44 |
44 |
$544.82 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
14 |
13 |
$538.02 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
195 |
195 |
$194.04 |
| 96127 |
|
116 |
116 |
$104.72 |
| 96160 |
|
115 |
115 |
$91.12 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
98 |
98 |
$0.00 |
| 92551 |
|
189 |
189 |
$0.00 |
| 96161 |
|
13 |
13 |
$0.00 |
| G9920 |
Screening performed and negative |
201 |
201 |
$0.00 |