| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,652 |
1,537 |
$118K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,091 |
1,045 |
$55K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,389 |
1,384 |
$54K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
224 |
224 |
$17K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
174 |
172 |
$12K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
138 |
137 |
$10K |
| 87428 |
|
90 |
88 |
$6K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
223 |
217 |
$5K |
| 92551 |
|
384 |
384 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
14 |
14 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
93 |
92 |
$1K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
18 |
18 |
$768.91 |
| 87807 |
|
61 |
58 |
$528.42 |
| 99173 |
|
208 |
208 |
$409.58 |
| 99174 |
|
13 |
13 |
$49.14 |
| 85018 |
|
24 |
24 |
$40.48 |
| 81000 |
|
12 |
12 |
$33.72 |
| 36416 |
|
37 |
37 |
$1.64 |
| 94760 |
|
197 |
179 |
$0.00 |
| 99000 |
|
12 |
12 |
$0.00 |