| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,135 |
951 |
$85K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,160 |
1,063 |
$44K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
369 |
358 |
$28K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,430 |
781 |
$26K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
123 |
121 |
$7K |
| 99460 |
|
70 |
68 |
$5K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
478 |
455 |
$4K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
77 |
77 |
$4K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
184 |
118 |
$2K |
| 90461 |
|
650 |
571 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
33 |
33 |
$364.50 |
| 87999 |
|
178 |
163 |
$181.50 |
| 87807 |
|
12 |
12 |
$138.60 |
| 90723 |
|
297 |
269 |
$0.00 |
| 36416 |
|
74 |
67 |
$0.00 |
| 90686 |
|
112 |
103 |
$0.00 |
| 90671 |
|
209 |
192 |
$0.00 |
| 90681 |
|
228 |
204 |
$0.00 |
| 90648 |
|
443 |
409 |
$0.00 |
| 90670 |
|
188 |
173 |
$0.00 |
| 90633 |
|
25 |
25 |
$0.00 |
| 99051 |
|
15 |
14 |
$0.00 |