| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,264 |
1,951 |
$262K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
184 |
174 |
$22K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
327 |
310 |
$21K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
91 |
91 |
$11K |
| 99215 |
Prolong outpt/office vis |
55 |
55 |
$8K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
61 |
61 |
$7K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
392 |
195 |
$6K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
146 |
145 |
$6K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
54 |
53 |
$6K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
283 |
276 |
$5K |
| 99239 |
Hospital discharge day management, more than 30 minutes |
24 |
24 |
$2K |
| 92552 |
|
142 |
142 |
$603.34 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
106 |
100 |
$420.80 |
| 92551 |
|
108 |
108 |
$22.32 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
44 |
44 |
$12.56 |
| 99173 |
|
313 |
312 |
$10.88 |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
241 |
239 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
17 |
17 |
$0.00 |