| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
748 |
704 |
$26K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
228 |
210 |
$12K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,139 |
550 |
$8K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
54 |
49 |
$4K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
32 |
32 |
$3K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
28 |
26 |
$2K |
| 90461 |
|
175 |
102 |
$1K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
97 |
94 |
$1K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
28 |
28 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$1K |
| 99000 |
|
47 |
47 |
$496.80 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
61 |
46 |
$407.00 |
| 94760 |
|
174 |
161 |
$262.34 |
| 81002 |
|
47 |
47 |
$137.24 |
| 96160 |
|
73 |
51 |
$119.75 |
| CP002 |
|
12 |
12 |
$117.60 |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
80 |
71 |
$56.92 |
| 90686 |
|
113 |
112 |
$0.00 |
| 90688 |
|
56 |
56 |
$0.00 |
| 99072 |
|
1,466 |
1,279 |
$0.00 |
| 99051 |
|
27 |
26 |
$0.00 |
| 90670 |
|
12 |
12 |
$0.00 |
| A4327 |
Female external urinary collection device; meatal cup, each |
15 |
15 |
$0.00 |