| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,088 |
2,975 |
$146K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,759 |
1,690 |
$121K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
3,094 |
3,027 |
$110K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,315 |
1,305 |
$91K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,156 |
1,141 |
$79K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,986 |
1,945 |
$50K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
654 |
619 |
$43K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
490 |
484 |
$36K |
| 90461 |
|
1,137 |
1,114 |
$12K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
157 |
153 |
$4K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
360 |
177 |
$3K |
| 99188 |
|
226 |
224 |
$3K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
419 |
417 |
$2K |
| 92587 |
|
612 |
600 |
$2K |
| 96127 |
|
564 |
557 |
$2K |
| 94760 |
|
1,662 |
1,613 |
$2K |
| 92551 |
|
904 |
893 |
$2K |
| 36416 |
|
290 |
285 |
$569.80 |
| 90685 |
|
38 |
36 |
$414.04 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
42 |
41 |
$333.88 |
| 92567 |
|
13 |
13 |
$117.39 |
| 90686 |
|
707 |
684 |
$64.86 |
| 85018 |
|
15 |
14 |
$18.66 |
| 96161 |
|
39 |
37 |
$9.09 |
| 94761 |
|
16 |
15 |
$6.68 |
| 99173 |
|
973 |
965 |
$0.00 |
| 90670 |
|
319 |
315 |
$0.00 |
| 90672 |
|
262 |
250 |
$0.00 |
| 90633 |
|
56 |
53 |
$0.00 |
| 90734 |
|
13 |
13 |
$0.00 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
28 |
28 |
$0.00 |
| 97802 |
|
1,396 |
1,387 |
$0.00 |
| 99000 |
|
946 |
928 |
$0.00 |
| 90656 |
|
18 |
18 |
$0.00 |
| 90680 |
|
100 |
98 |
$0.00 |
| A7015 |
Aerosol mask, used with dme nebulizer |
40 |
40 |
$0.00 |
| 90698 |
|
166 |
163 |
$0.00 |
| 90660 |
|
18 |
18 |
$0.00 |
| 90651 |
|
29 |
29 |
$0.00 |