| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,623 |
2,161 |
$92K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
345 |
312 |
$26K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
320 |
318 |
$25K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,811 |
827 |
$14K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
132 |
132 |
$11K |
| 90461 |
|
606 |
518 |
$4K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
578 |
573 |
$3K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
31 |
25 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
14 |
14 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
59 |
30 |
$809.01 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
14 |
14 |
$634.32 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
13 |
13 |
$310.48 |
| S8301 |
Infection control supplies, not otherwise specified |
22 |
21 |
$119.70 |
| 90688 |
|
48 |
48 |
$18.06 |
| 90680 |
|
99 |
99 |
$0.00 |
| 90723 |
|
56 |
55 |
$0.00 |
| 90648 |
|
94 |
92 |
$0.00 |
| 90670 |
|
231 |
229 |
$0.00 |
| 90473 |
|
99 |
99 |
$0.00 |
| 90633 |
|
15 |
15 |
$0.00 |
| 90710 |
|
13 |
13 |
$0.00 |