| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,010 |
3,648 |
$358K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,061 |
1,061 |
$124K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,011 |
1,011 |
$109K |
| 92552 |
|
3,222 |
3,217 |
$106K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,921 |
2,895 |
$71K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
792 |
790 |
$40K |
| 99401 |
|
3,175 |
3,172 |
$29K |
| G0008 |
Administration of influenza virus vaccine |
1,489 |
1,488 |
$26K |
| 86580 |
|
2,060 |
2,055 |
$18K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
166 |
166 |
$18K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
128 |
128 |
$14K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
959 |
917 |
$12K |
| 90461 |
|
214 |
214 |
$5K |
| 96150 |
|
740 |
738 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
709 |
708 |
$2K |
| 97802 |
|
948 |
946 |
$2K |
| 90621 |
|
55 |
55 |
$2K |
| 99173 |
|
3,004 |
3,002 |
$1K |
| 90672 |
|
1,229 |
1,228 |
$1K |
| 0072A |
|
23 |
23 |
$953.51 |
| 0071A |
|
23 |
23 |
$941.43 |
| 90686 |
|
680 |
680 |
$889.49 |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
18 |
17 |
$655.97 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
28 |
28 |
$500.77 |
| 90688 |
|
482 |
482 |
$469.91 |
| 90660 |
|
203 |
203 |
$219.78 |
| 90619 |
|
44 |
44 |
$168.46 |
| 83655 |
|
15 |
15 |
$152.58 |
| 90658 |
|
63 |
63 |
$86.29 |
| 90651 |
|
115 |
115 |
$0.00 |
| 91307 |
|
63 |
62 |
$0.00 |
| 99000 |
|
18 |
17 |
$0.00 |
| 90734 |
|
146 |
146 |
$0.00 |
| 90633 |
|
13 |
13 |
$0.00 |
| 90685 |
|
28 |
28 |
$0.00 |
| 90707 |
|
12 |
12 |
$0.00 |