| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,052 |
1,010 |
$41K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
134 |
133 |
$6K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
79 |
76 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
52 |
41 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
27 |
25 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12 |
12 |
$600.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
13 |
13 |
$185.05 |
| 96127 |
|
43 |
43 |
$75.50 |
| 90656 |
|
14 |
14 |
$39.46 |
| 90686 |
|
17 |
15 |
$20.03 |
| 96160 |
|
13 |
13 |
$12.28 |