| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
643 |
613 |
$24K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
233 |
221 |
$11K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
431 |
407 |
$9K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
88 |
86 |
$3K |
| 90671 |
|
14 |
14 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
222 |
215 |
$3K |
| 92551 |
|
246 |
242 |
$3K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
92 |
91 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
46 |
46 |
$2K |
| 90619 |
|
14 |
14 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
28 |
27 |
$1K |
| 90461 |
|
110 |
107 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
15 |
15 |
$750.00 |
| 96127 |
|
95 |
95 |
$272.57 |
| 36416 |
|
15 |
15 |
$150.00 |
| 90656 |
|
35 |
35 |
$133.48 |
| 90686 |
|
75 |
71 |
$103.55 |
| 90700 |
|
40 |
40 |
$58.62 |
| 99401 |
|
55 |
54 |
$46.05 |
| 90744 |
|
12 |
12 |
$28.42 |
| 85018 |
|
15 |
15 |
$17.16 |
| 99000 |
|
53 |
53 |
$0.00 |
| 99173 |
|
252 |
249 |
$0.00 |
| 96160 |
|
12 |
12 |
$0.00 |