| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
951 |
922 |
$79K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,560 |
1,374 |
$63K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
767 |
710 |
$57K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
545 |
530 |
$45K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
312 |
300 |
$24K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
653 |
565 |
$16K |
| 92587 |
|
782 |
724 |
$9K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
940 |
900 |
$5K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,501 |
1,444 |
$5K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
65 |
54 |
$4K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
478 |
228 |
$3K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
389 |
383 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
154 |
134 |
$1K |
| 85018 |
|
259 |
252 |
$374.53 |
| 90473 |
|
75 |
72 |
$140.00 |
| 87807 |
|
14 |
13 |
$124.56 |
| 94760 |
|
119 |
97 |
$89.58 |
| 1160F |
|
3,031 |
2,525 |
$71.47 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
36 |
31 |
$61.50 |
| 90686 |
|
530 |
511 |
$21.88 |
| 90677 |
|
12 |
12 |
$0.01 |
| 90633 |
|
190 |
182 |
$0.01 |
| 3074F |
|
3,206 |
2,768 |
$0.00 |
| 1126F |
|
59 |
52 |
$0.00 |
| 99174 |
|
614 |
502 |
$0.00 |
| 1036F |
|
3,859 |
3,028 |
$0.00 |
| 90723 |
|
262 |
257 |
$0.00 |
| 36416 |
|
172 |
155 |
$0.00 |
| 3008F |
|
4,630 |
3,726 |
$0.00 |
| 90651 |
|
77 |
74 |
$0.00 |
| 99000 |
|
155 |
124 |
$0.00 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
149 |
126 |
$0.00 |
| 90674 |
|
25 |
24 |
$0.00 |
| 3078F |
|
3,359 |
2,604 |
$0.00 |
| 3725F |
|
1,398 |
1,103 |
$0.00 |
| 90648 |
|
451 |
438 |
$0.00 |
| 90681 |
|
57 |
57 |
$0.00 |
| 90670 |
|
290 |
284 |
$0.00 |
| 90734 |
|
49 |
49 |
$0.00 |
| 90671 |
|
136 |
129 |
$0.00 |
| 90700 |
|
13 |
13 |
$0.00 |
| 99173 |
|
16 |
14 |
$0.00 |
| 90710 |
|
12 |
12 |
$0.00 |