| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,186 |
1,140 |
$81K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
749 |
738 |
$34K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
105 |
104 |
$8K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
78 |
78 |
$6K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
53 |
53 |
$4K |
| 99215 |
Prolong outpt/office vis |
13 |
12 |
$1K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
25 |
25 |
$922.32 |
| 90686 |
|
137 |
131 |
$894.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
40 |
40 |
$535.27 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
52 |
26 |
$524.58 |
| 87428 |
|
12 |
12 |
$351.48 |
| 92551 |
|
53 |
53 |
$26.00 |
| 96127 |
|
27 |
27 |
$16.72 |
| 96160 |
|
27 |
27 |
$10.72 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
13 |
13 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
12 |
12 |
$0.00 |
| G9920 |
Screening performed and negative |
45 |
45 |
$0.00 |
| 90670 |
|
12 |
12 |
$0.00 |