| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
984 |
935 |
$44K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
387 |
377 |
$27K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
895 |
892 |
$10K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
208 |
207 |
$5K |
| 90688 |
|
94 |
94 |
$2K |
| 90686 |
|
132 |
132 |
$1K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
26 |
26 |
$1K |
| 87428 |
|
14 |
14 |
$925.96 |
| 0002A |
|
17 |
17 |
$680.00 |
| 0001A |
|
16 |
16 |
$640.00 |
| 90461 |
|
32 |
32 |
$560.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
14 |
14 |
$558.60 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
13 |
13 |
$518.70 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12 |
12 |
$478.80 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
13 |
13 |
$330.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
30 |
29 |
$53.40 |
| 91300 |
|
41 |
39 |
$2.00 |
| 96127 |
|
52 |
52 |
$0.00 |
| 91307 |
|
12 |
12 |
$0.00 |
| 99051 |
|
244 |
243 |
$0.00 |
| 96160 |
|
28 |
28 |
$0.00 |