| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,349 |
1,166 |
$47K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,799 |
1,595 |
$44K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
357 |
325 |
$25K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
3,253 |
1,713 |
$24K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
3,046 |
2,999 |
$23K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
212 |
187 |
$15K |
| 87428 |
|
304 |
208 |
$5K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
66 |
64 |
$4K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
214 |
193 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
310 |
289 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
118 |
109 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
26 |
25 |
$2K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
53 |
49 |
$1K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
104 |
101 |
$776.94 |
| 96160 |
|
657 |
535 |
$747.98 |
| 90461 |
|
87 |
47 |
$325.36 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
38 |
36 |
$200.58 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
14 |
12 |
$166.21 |
| 97170 |
|
14 |
13 |
$100.00 |
| 90474 |
|
12 |
12 |
$96.00 |
| 81003 |
|
59 |
54 |
$76.15 |
| 90677 |
|
48 |
47 |
$0.27 |
| 90671 |
|
34 |
34 |
$0.18 |
| 90715 |
|
337 |
327 |
$0.17 |
| 90651 |
|
493 |
471 |
$0.05 |
| 90734 |
|
693 |
670 |
$0.02 |
| 90686 |
|
692 |
639 |
$0.02 |
| 90707 |
|
45 |
45 |
$0.01 |
| 90670 |
|
324 |
315 |
$0.00 |
| 90633 |
|
207 |
205 |
$0.00 |
| 90710 |
|
111 |
110 |
$0.00 |
| 90700 |
|
43 |
43 |
$0.00 |
| 90648 |
|
28 |
27 |
$0.00 |
| 90713 |
|
17 |
17 |
$0.00 |
| 90656 |
|
18 |
18 |
$0.00 |
| 90716 |
|
46 |
46 |
$0.00 |
| 90698 |
|
44 |
43 |
$0.00 |
| 90696 |
|
15 |
15 |
$0.00 |
| 90744 |
|
44 |
43 |
$0.00 |
| 90620 |
|
60 |
60 |
$0.00 |
| 90680 |
|
12 |
12 |
$0.00 |
| S8301 |
Infection control supplies, not otherwise specified |
24 |
13 |
$0.00 |