| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,787 |
1,761 |
$76K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
711 |
707 |
$46K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
156 |
156 |
$7K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
52 |
52 |
$6K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
39 |
39 |
$4K |
| 92551 |
|
664 |
662 |
$4K |
| 99173 |
|
666 |
664 |
$4K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
28 |
28 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
197 |
197 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
35 |
35 |
$985.30 |
| 90686 |
|
53 |
41 |
$377.00 |
| 96127 |
|
50 |
50 |
$12.08 |
| 96160 |
|
77 |
77 |
$5.99 |
| 3008F |
|
455 |
454 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
13 |
13 |
$0.00 |
| 90656 |
|
12 |
12 |
$0.00 |
| 90671 |
|
13 |
13 |
$0.00 |
| G9920 |
Screening performed and negative |
12 |
12 |
$0.00 |