| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,776 |
1,595 |
$138K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
938 |
876 |
$102K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
390 |
390 |
$37K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
756 |
747 |
$28K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
179 |
177 |
$15K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
116 |
115 |
$10K |
| D0190 |
|
68 |
68 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
135 |
101 |
$1K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
17 |
17 |
$582.44 |
| 99188 |
|
68 |
68 |
$483.70 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
33 |
17 |
$423.66 |
| 99177 |
|
128 |
128 |
$397.48 |
| 92551 |
|
43 |
43 |
$331.04 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
13 |
13 |
$174.16 |
| 97802 |
|
276 |
275 |
$15.00 |
| 90461 |
|
380 |
379 |
$0.00 |
| 90648 |
|
102 |
102 |
$0.00 |
| 90670 |
|
68 |
68 |
$0.00 |
| 90681 |
|
12 |
12 |
$0.00 |
| 90633 |
|
12 |
12 |
$0.00 |
| 90686 |
|
172 |
170 |
$0.00 |
| 90656 |
|
26 |
26 |
$0.00 |
| 90723 |
|
14 |
14 |
$0.00 |