| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,292 |
2,017 |
$75K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
861 |
861 |
$63K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
752 |
715 |
$54K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
3,950 |
1,877 |
$30K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
372 |
372 |
$28K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
621 |
581 |
$27K |
| 90461 |
|
1,041 |
919 |
$7K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
690 |
690 |
$6K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
64 |
64 |
$5K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
325 |
162 |
$4K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
98 |
91 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
139 |
132 |
$2K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
44 |
39 |
$2K |
| 99381 |
|
12 |
12 |
$947.43 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
45 |
43 |
$597.55 |
| 87807 |
|
32 |
30 |
$302.29 |
| 86580 |
|
13 |
13 |
$83.98 |
| 1159F |
|
396 |
345 |
$0.00 |
| 3078F |
|
265 |
225 |
$0.00 |
| 90648 |
|
51 |
51 |
$0.00 |
| 1160F |
|
396 |
345 |
$0.00 |
| 90707 |
|
140 |
140 |
$0.00 |
| 90633 |
|
238 |
238 |
$0.00 |
| 90670 |
|
536 |
536 |
$0.00 |
| 90700 |
|
15 |
15 |
$0.00 |
| 3074F |
|
272 |
231 |
$0.00 |
| 90716 |
|
149 |
149 |
$0.00 |
| 90698 |
|
378 |
377 |
$0.00 |
| 90744 |
|
208 |
206 |
$0.00 |
| 90680 |
|
280 |
280 |
$0.00 |
| 1036F |
|
715 |
585 |
$0.00 |
| 90686 |
|
609 |
607 |
$0.00 |
| 3008F |
|
609 |
500 |
$0.00 |