| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
17,444 |
15,581 |
$897K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
7,113 |
6,926 |
$342K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
727 |
714 |
$58K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
527 |
523 |
$44K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
471 |
462 |
$34K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
512 |
440 |
$32K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
681 |
661 |
$26K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,135 |
952 |
$15K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
119 |
119 |
$11K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
861 |
807 |
$11K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
284 |
278 |
$10K |
| 0071A |
|
53 |
51 |
$4K |
| 96127 |
|
290 |
290 |
$1K |
| 0072A |
|
13 |
13 |
$1K |
| 0002A |
|
14 |
14 |
$397.46 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
13 |
13 |
$260.60 |
| 94760 |
|
34 |
34 |
$39.29 |
| 90686 |
|
556 |
525 |
$15.00 |
| 99000 |
|
40 |
39 |
$6.00 |
| 90674 |
|
34 |
34 |
$0.00 |
| 90680 |
|
24 |
24 |
$0.00 |
| 90651 |
|
13 |
13 |
$0.00 |
| 90744 |
|
14 |
14 |
$0.00 |
| 90688 |
|
16 |
14 |
$0.00 |
| 90713 |
|
212 |
208 |
$0.00 |
| 90700 |
|
431 |
420 |
$0.00 |
| 90670 |
|
192 |
182 |
$0.00 |
| 90648 |
|
172 |
163 |
$0.00 |
| 90685 |
|
43 |
38 |
$0.00 |