| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,981 |
3,498 |
$381K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,739 |
3,013 |
$251K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
1,236 |
936 |
$44K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
401 |
340 |
$34K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
3,411 |
2,535 |
$22K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
170 |
144 |
$14K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
150 |
109 |
$10K |
| H2015 |
Comprehensive community support services, per 15 minutes |
77 |
59 |
$9K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
406 |
164 |
$5K |
| 90461 |
|
1,647 |
729 |
$5K |
| 87430 |
|
220 |
164 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
28 |
13 |
$891.93 |
| 99173 |
|
33 |
33 |
$379.71 |
| 87081 |
|
89 |
58 |
$341.28 |
| 87807 |
|
12 |
12 |
$164.97 |
| 99072 |
|
86 |
59 |
$150.00 |
| 85018 |
|
31 |
25 |
$24.36 |
| 90686 |
|
244 |
244 |
$0.01 |
| 90655 |
|
17 |
14 |
$0.00 |
| 90670 |
|
26 |
13 |
$0.00 |
| 90656 |
|
833 |
631 |
$0.00 |
| 99000 |
|
17 |
17 |
$0.00 |