| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,294 |
1,117 |
$132K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
89 |
84 |
$7K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
16 |
13 |
$3K |
| 87428 |
|
34 |
34 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
15 |
14 |
$2K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
35 |
35 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
188 |
186 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
43 |
42 |
$627.80 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
15 |
15 |
$625.66 |
| 90658 |
|
14 |
14 |
$338.76 |
| 99051 |
|
13 |
13 |
$215.28 |
| 81025 |
|
12 |
12 |
$91.08 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
12 |
12 |
$27.72 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
15 |
15 |
$0.00 |