| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,923 |
3,551 |
$197K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,252 |
1,239 |
$40K |
| 87428 |
|
520 |
505 |
$21K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
136 |
136 |
$8K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
364 |
350 |
$7K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
97 |
97 |
$6K |
| 92551 |
|
717 |
716 |
$6K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
89 |
89 |
$6K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
97 |
97 |
$6K |
| 99402 |
|
386 |
386 |
$5K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
549 |
533 |
$4K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
464 |
456 |
$3K |
| 87081 |
|
460 |
448 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
28 |
28 |
$2K |
| 87184 |
|
448 |
437 |
$1K |
| 81000 |
|
490 |
481 |
$1K |
| 99173 |
|
409 |
408 |
$763.97 |
| 0072A |
|
13 |
13 |
$520.00 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
14 |
14 |
$367.90 |
| 81003 |
|
170 |
170 |
$260.93 |
| 99401 |
|
384 |
384 |
$141.96 |
| 99000 |
|
376 |
363 |
$3.35 |
| 90686 |
|
12 |
12 |
$0.00 |
| 99072 |
|
13 |
13 |
$0.00 |