| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,223 |
1,067 |
$40K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
317 |
281 |
$22K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
285 |
271 |
$18K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
384 |
337 |
$17K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
701 |
623 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
43 |
40 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
235 |
210 |
$616.03 |
| 90461 |
|
356 |
288 |
$204.00 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
14 |
12 |
$97.68 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
13 |
13 |
$49.24 |
| 90674 |
|
21 |
13 |
$20.00 |
| 99173 |
|
231 |
180 |
$0.00 |
| 94760 |
|
78 |
62 |
$0.00 |
| 90686 |
|
18 |
16 |
$0.00 |
| 90698 |
|
23 |
15 |
$0.00 |