| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,705 |
1,459 |
$62K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,707 |
766 |
$15K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
171 |
156 |
$9K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
286 |
272 |
$4K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
88 |
77 |
$3K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
103 |
84 |
$3K |
| 99000 |
|
264 |
242 |
$2K |
| 90461 |
|
158 |
115 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
74 |
37 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
12 |
12 |
$913.33 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
12 |
12 |
$685.80 |
| 87428 |
|
14 |
13 |
$402.22 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
14 |
14 |
$209.44 |
| 90686 |
|
303 |
248 |
$11.62 |
| 96127 |
|
12 |
12 |
$8.75 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$0.00 |
| 90656 |
|
12 |
12 |
$0.00 |