| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
123 |
121 |
$31K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
197 |
191 |
$16K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
113 |
113 |
$9K |
| 87428 |
|
50 |
50 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
32 |
32 |
$4K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
111 |
111 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
13 |
13 |
$2K |
| 96127 |
|
72 |
72 |
$1K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
33 |
33 |
$820.10 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
12 |
12 |
$560.76 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
12 |
12 |
$560.76 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
13 |
13 |
$201.63 |