| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,781 |
1,756 |
$162K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,530 |
1,495 |
$147K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,590 |
1,568 |
$136K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,240 |
1,215 |
$104K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
8,247 |
4,364 |
$95K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
8,302 |
7,412 |
$70K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
4,691 |
4,491 |
$33K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,832 |
1,773 |
$25K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,373 |
965 |
$12K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
312 |
303 |
$10K |
| 99253 |
|
97 |
89 |
$9K |
| 90461 |
|
2,185 |
1,861 |
$8K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
51 |
50 |
$3K |
| 0002A |
|
36 |
35 |
$1K |
| 99381 |
|
15 |
15 |
$928.43 |
| 0001A |
|
33 |
33 |
$920.00 |
| 90620 |
|
40 |
40 |
$434.78 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
190 |
93 |
$428.12 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
135 |
131 |
$351.44 |
| 90651 |
|
405 |
404 |
$290.26 |
| 90686 |
|
699 |
696 |
$207.94 |
| 99051 |
|
29 |
29 |
$147.87 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
12 |
12 |
$132.72 |
| 90688 |
|
639 |
629 |
$116.42 |
| 99000 |
|
15 |
15 |
$35.64 |
| 90672 |
|
126 |
126 |
$27.18 |
| 90656 |
|
174 |
173 |
$19.76 |
| 90619 |
|
178 |
177 |
$0.08 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
20 |
20 |
$0.00 |
| 90715 |
|
82 |
80 |
$0.00 |
| 90633 |
|
315 |
309 |
$0.00 |
| 90734 |
|
176 |
174 |
$0.00 |
| 90710 |
|
139 |
139 |
$0.00 |
| 90681 |
|
90 |
90 |
$0.00 |
| 90648 |
|
129 |
128 |
$0.00 |
| 90670 |
|
644 |
635 |
$0.00 |
| 90671 |
|
388 |
382 |
$0.00 |
| 91300 |
|
84 |
77 |
$0.00 |
| 90680 |
|
423 |
416 |
$0.00 |
| 90697 |
|
322 |
316 |
$0.00 |
| 90698 |
|
34 |
34 |
$0.00 |
| 90723 |
|
58 |
58 |
$0.00 |