| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
463 |
420 |
$22K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
336 |
316 |
$12K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
364 |
164 |
$5K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
90 |
88 |
$4K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
48 |
48 |
$3K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
223 |
109 |
$3K |
| 99429 |
|
47 |
47 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
152 |
129 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
13 |
13 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
14 |
14 |
$1K |
| 87430 |
|
77 |
77 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
13 |
13 |
$1K |
| 96380 |
|
15 |
15 |
$266.31 |
| 87807 |
|
17 |
15 |
$187.00 |
| 96160 |
|
19 |
19 |
$43.08 |
| 90677 |
|
20 |
20 |
$0.10 |
| 90686 |
|
25 |
25 |
$0.00 |
| 90680 |
|
14 |
14 |
$0.00 |