| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
346 |
315 |
$19K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
154 |
145 |
$6K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
53 |
53 |
$5K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
31 |
31 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
103 |
77 |
$942.46 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
58 |
30 |
$921.14 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
84 |
36 |
$730.00 |
| 90461 |
|
13 |
12 |
$95.26 |
| 90686 |
|
13 |
13 |
$0.00 |