| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,847 |
1,735 |
$93K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,893 |
1,772 |
$70K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
124 |
124 |
$11K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,069 |
529 |
$10K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
81 |
81 |
$6K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
104 |
100 |
$4K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
188 |
94 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
135 |
134 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12 |
12 |
$945.02 |
| 90461 |
|
135 |
113 |
$827.79 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
30 |
30 |
$273.80 |
| 92552 |
|
24 |
24 |
$240.00 |
| 96160 |
|
54 |
54 |
$66.72 |
| 90686 |
|
29 |
29 |
$0.01 |
| 90651 |
|
26 |
26 |
$0.00 |
| G8483 |
Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons) |
117 |
117 |
$0.00 |
| 90734 |
|
12 |
12 |
$0.00 |
| 99072 |
|
13 |
13 |
$0.00 |