| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,429 |
1,294 |
$61K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
2,700 |
1,472 |
$59K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,916 |
998 |
$59K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
517 |
473 |
$34K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
453 |
358 |
$30K |
| 96160 |
|
2,040 |
938 |
$25K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
334 |
272 |
$24K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
125 |
105 |
$9K |
| 99177 |
|
797 |
661 |
$5K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
532 |
496 |
$5K |
| 92551 |
|
684 |
546 |
$5K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
342 |
166 |
$3K |
| 99173 |
|
467 |
365 |
$3K |
| 90670 |
|
307 |
259 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
15 |
15 |
$1K |
| 90461 |
|
738 |
527 |
$337.80 |
| 36415 |
Collection of venous blood by venipuncture |
145 |
112 |
$288.32 |
| 90680 |
|
60 |
52 |
$220.62 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
15 |
15 |
$200.00 |
| 83655 |
|
12 |
12 |
$173.33 |
| 85018 |
|
71 |
68 |
$158.28 |
| 90686 |
|
275 |
230 |
$156.75 |
| 90698 |
|
92 |
81 |
$127.31 |
| 90688 |
|
146 |
103 |
$43.25 |
| 99000 |
|
210 |
174 |
$0.00 |
| 90744 |
|
27 |
27 |
$0.00 |