| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 87428 |
|
6,438 |
2,168 |
$422K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
8,319 |
7,591 |
$288K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,917 |
1,814 |
$96K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
608 |
591 |
$45K |
| 92587 |
|
2,634 |
2,575 |
$41K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
3,926 |
1,767 |
$31K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,949 |
1,837 |
$26K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
308 |
302 |
$24K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,415 |
1,386 |
$19K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
157 |
154 |
$14K |
| 99000 |
|
977 |
929 |
$11K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
760 |
388 |
$8K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
86 |
86 |
$4K |
| 90461 |
|
410 |
348 |
$3K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
178 |
86 |
$3K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
31 |
24 |
$2K |
| 87807 |
|
151 |
142 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
166 |
126 |
$1K |
| 99050 |
|
41 |
38 |
$556.51 |
| 96160 |
|
226 |
224 |
$452.25 |
| 99051 |
|
16 |
14 |
$108.78 |
| 90686 |
|
822 |
794 |
$2.65 |
| 1033F |
|
4,533 |
4,306 |
$0.00 |
| 99072 |
|
4,741 |
4,247 |
$0.00 |
| 90671 |
|
16 |
12 |
$0.00 |
| 90633 |
|
13 |
13 |
$0.00 |
| 90670 |
|
12 |
12 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
172 |
172 |
$0.00 |
| 90656 |
|
96 |
96 |
$0.00 |
| 99058 |
|
13 |
12 |
$0.00 |