| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,015 |
2,601 |
$107K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
798 |
745 |
$40K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,570 |
1,074 |
$21K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
241 |
239 |
$19K |
| Q3014 |
Telehealth originating site facility fee |
784 |
695 |
$16K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
149 |
141 |
$11K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
134 |
134 |
$11K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
90 |
90 |
$8K |
| 90461 |
|
488 |
427 |
$4K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
385 |
301 |
$3K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
46 |
45 |
$2K |
| 99429 |
|
42 |
41 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
12 |
12 |
$746.51 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
48 |
24 |
$713.12 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
18 |
13 |
$473.10 |
| 92551 |
|
827 |
818 |
$354.63 |
| 96160 |
|
49 |
49 |
$124.52 |
| 99173 |
|
827 |
815 |
$8.16 |
| 90648 |
|
124 |
123 |
$0.00 |
| 90633 |
|
24 |
24 |
$0.00 |
| 90670 |
|
142 |
139 |
$0.00 |
| 90686 |
|
452 |
442 |
$0.00 |
| 90723 |
|
62 |
62 |
$0.00 |
| 90651 |
|
13 |
13 |
$0.00 |