| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
927 |
902 |
$70K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,362 |
1,305 |
$66K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
452 |
452 |
$43K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
342 |
342 |
$32K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
228 |
225 |
$21K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
94 |
94 |
$9K |
| 99215 |
Prolong outpt/office vis |
13 |
13 |
$1K |
| 87428 |
|
29 |
29 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
62 |
62 |
$860.73 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
12 |
12 |
$461.16 |
| 90686 |
|
167 |
167 |
$319.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
377 |
377 |
$270.17 |
| 90670 |
|
76 |
76 |
$209.00 |
| 96127 |
|
289 |
285 |
$181.06 |
| 99177 |
|
123 |
123 |
$132.15 |
| 96160 |
|
264 |
260 |
$130.76 |
| 92551 |
|
649 |
643 |
$104.00 |
| 99173 |
|
159 |
154 |
$71.00 |
| 90648 |
|
103 |
103 |
$33.00 |
| 85018 |
|
12 |
12 |
$8.63 |
| 90680 |
|
26 |
26 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
125 |
124 |
$0.00 |
| 90723 |
|
39 |
39 |
$0.00 |
| 96161 |
|
86 |
84 |
$0.00 |
| 90677 |
|
44 |
44 |
$0.00 |
| 83655 |
|
12 |
12 |
$0.00 |
| G9920 |
Screening performed and negative |
366 |
365 |
$0.00 |
| 90661 |
|
57 |
57 |
$0.00 |