| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
592 |
540 |
$30K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
313 |
285 |
$23K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
16 |
16 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
17 |
17 |
$1K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
17 |
16 |
$1K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
246 |
175 |
$902.90 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
13 |
13 |
$425.88 |
| 99072 |
|
850 |
718 |
$19.71 |
| 90461 |
|
24 |
15 |
$13.70 |
| 83655 |
|
14 |
14 |
$0.00 |
| 99000 |
|
12 |
12 |
$0.00 |