| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,089 |
1,827 |
$115K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,456 |
1,257 |
$96K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
75 |
75 |
$8K |
| 87428 |
|
142 |
142 |
$8K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
611 |
574 |
$5K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
49 |
46 |
$5K |
| 99051 |
|
165 |
160 |
$4K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
53 |
51 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
24 |
24 |
$3K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
67 |
67 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
198 |
197 |
$2K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
75 |
74 |
$912.76 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
36 |
32 |
$625.44 |
| 90461 |
|
18 |
17 |
$616.64 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
30 |
15 |
$345.20 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
13 |
13 |
$140.31 |
| 96127 |
|
41 |
39 |
$120.25 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
13 |
12 |
$73.39 |