| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,474 |
2,102 |
$96K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,018 |
928 |
$52K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
951 |
937 |
$31K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
260 |
260 |
$15K |
| 92587 |
|
332 |
332 |
$12K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
135 |
135 |
$9K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
862 |
859 |
$8K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
232 |
111 |
$3K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
102 |
101 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
305 |
296 |
$2K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
68 |
66 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
30 |
29 |
$2K |
| 87428 |
|
26 |
24 |
$1K |
| 81003 |
|
246 |
240 |
$360.29 |
| 99173 |
|
136 |
136 |
$268.00 |
| 96127 |
|
14 |
14 |
$36.96 |
| 99000 |
|
25 |
25 |
$0.00 |
| 96160 |
|
27 |
27 |
$0.00 |