| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
515 |
477 |
$22K |
| 87428 |
|
216 |
209 |
$9K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
112 |
110 |
$6K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
167 |
166 |
$6K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
37 |
37 |
$2K |
| 92551 |
|
155 |
155 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
19 |
19 |
$1K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
34 |
33 |
$799.72 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
35 |
35 |
$420.50 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
62 |
60 |
$394.70 |
| 81000 |
|
142 |
141 |
$317.73 |
| 87081 |
|
36 |
36 |
$135.80 |
| 87184 |
|
36 |
36 |
$123.07 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
13 |
13 |
$95.64 |
| 99000 |
|
18 |
18 |
$0.00 |