| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,715 |
2,505 |
$126K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
625 |
574 |
$41K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
381 |
375 |
$36K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
236 |
231 |
$19K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
163 |
162 |
$16K |
| 99188 |
|
207 |
195 |
$3K |
| 90686 |
|
278 |
275 |
$2K |
| 99177 |
|
108 |
102 |
$2K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
32 |
32 |
$850.04 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
18 |
18 |
$662.16 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
34 |
26 |
$506.36 |
| 0002A |
|
12 |
12 |
$504.00 |
| 90670 |
|
76 |
75 |
$446.42 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
26 |
26 |
$413.01 |
| 90648 |
|
51 |
51 |
$288.86 |
| 90688 |
|
28 |
27 |
$288.86 |
| 92551 |
|
25 |
25 |
$148.44 |
| 90658 |
|
12 |
12 |
$131.30 |
| 99173 |
|
25 |
25 |
$62.40 |