| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
312 |
286 |
$16K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
353 |
332 |
$13K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
109 |
105 |
$9K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
100 |
99 |
$4K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
369 |
160 |
$3K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
195 |
113 |
$3K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
213 |
157 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
14 |
14 |
$1K |
| 87807 |
|
55 |
54 |
$666.98 |
| 90461 |
|
75 |
59 |
$526.63 |
| 90686 |
|
33 |
33 |
$0.00 |