| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,459 |
4,547 |
$190K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,276 |
1,198 |
$94K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,044 |
934 |
$76K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
968 |
919 |
$76K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
6,454 |
2,743 |
$65K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,290 |
1,173 |
$61K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
728 |
669 |
$59K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,737 |
1,611 |
$37K |
| 99429 |
|
1,003 |
934 |
$30K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
786 |
720 |
$29K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,494 |
687 |
$19K |
| 92587 |
|
1,242 |
1,106 |
$11K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
187 |
181 |
$9K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
781 |
689 |
$9K |
| 90461 |
|
2,871 |
1,566 |
$9K |
| 92015 |
Determination of refractive state |
539 |
523 |
$6K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
251 |
228 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
26 |
26 |
$1K |
| 90677 |
|
131 |
116 |
$665.46 |
| 90697 |
|
124 |
116 |
$74.17 |
| 90686 |
|
505 |
475 |
$23.24 |
| 90734 |
|
41 |
41 |
$0.04 |
| 90707 |
|
120 |
111 |
$0.02 |
| 90716 |
|
155 |
137 |
$0.01 |
| 90670 |
|
753 |
689 |
$0.01 |
| 90648 |
|
508 |
460 |
$0.01 |
| 90723 |
|
258 |
232 |
$0.00 |
| 90656 |
|
38 |
37 |
$0.00 |
| 90696 |
|
12 |
12 |
$0.00 |
| 90681 |
|
144 |
133 |
$0.00 |
| 90633 |
|
208 |
188 |
$0.00 |
| 90700 |
|
14 |
12 |
$0.00 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
14 |
14 |
$0.00 |