| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,029 |
1,836 |
$183K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,993 |
1,798 |
$132K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,354 |
1,319 |
$27K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
243 |
243 |
$22K |
| 97802 |
|
636 |
629 |
$15K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
51 |
51 |
$6K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
380 |
369 |
$5K |
| 90461 |
|
267 |
266 |
$4K |
| 86328 |
|
79 |
76 |
$3K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
74 |
71 |
$3K |
| 81003 |
|
1,272 |
1,237 |
$3K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
13 |
13 |
$851.76 |
| 90656 |
|
402 |
388 |
$0.00 |
| 90649 |
|
14 |
13 |
$0.00 |
| 90633 |
|
13 |
13 |
$0.00 |
| 90655 |
|
24 |
24 |
$0.00 |