| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
603 |
556 |
$44K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
103 |
102 |
$10K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
319 |
313 |
$9K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
92 |
92 |
$9K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
75 |
75 |
$7K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
67 |
67 |
$7K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
86 |
79 |
$4K |
| 90461 |
|
122 |
121 |
$4K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
183 |
166 |
$1K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
13 |
13 |
$1K |
| 96127 |
|
248 |
246 |
$995.16 |
| 88738 |
|
238 |
237 |
$880.89 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
32 |
14 |
$400.84 |
| 90686 |
|
13 |
13 |
$202.47 |
| 3008F |
|
341 |
336 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
227 |
222 |
$0.00 |