| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,159 |
1,030 |
$62K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
654 |
598 |
$56K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
201 |
196 |
$18K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
142 |
142 |
$15K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
123 |
121 |
$11K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
70 |
70 |
$6K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
199 |
187 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
53 |
53 |
$2K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
25 |
25 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
25 |
15 |
$649.28 |
| 87428 |
|
14 |
14 |
$243.75 |
| 80061 |
Lipid panel |
28 |
26 |
$64.60 |
| 96127 |
|
84 |
84 |
$48.40 |
| 92551 |
|
223 |
209 |
$35.20 |
| 96160 |
|
57 |
57 |
$34.47 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
183 |
133 |
$23.07 |
| 90686 |
|
42 |
42 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
24 |
24 |
$0.00 |
| G9920 |
Screening performed and negative |
261 |
235 |
$0.00 |
| 99177 |
|
12 |
12 |
$0.00 |