| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,678 |
1,557 |
$147K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,714 |
1,617 |
$133K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
795 |
789 |
$74K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,172 |
2,153 |
$40K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
360 |
352 |
$38K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
970 |
967 |
$32K |
| 90474 |
|
740 |
737 |
$14K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
696 |
689 |
$6K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
45 |
45 |
$4K |
| 99383 |
|
15 |
15 |
$2K |
| 99381 |
|
16 |
16 |
$2K |
| 96161 |
|
309 |
272 |
$2K |
| 83655 |
|
95 |
95 |
$1K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
12 |
12 |
$584.88 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
15 |
15 |
$441.60 |
| 85018 |
|
111 |
111 |
$234.21 |
| 87807 |
|
13 |
13 |
$151.45 |
| 96127 |
|
17 |
17 |
$67.32 |
| 90677 |
|
347 |
343 |
$0.59 |
| 90656 |
|
106 |
106 |
$0.01 |
| 90680 |
|
856 |
852 |
$0.00 |
| 90686 |
|
500 |
500 |
$0.00 |
| 90723 |
|
148 |
148 |
$0.00 |
| 90697 |
|
689 |
685 |
$0.00 |
| 90647 |
|
15 |
15 |
$0.00 |
| 90716 |
|
12 |
12 |
$0.00 |
| 90670 |
|
706 |
706 |
$0.00 |
| 90633 |
|
274 |
274 |
$0.00 |
| 90700 |
|
14 |
14 |
$0.00 |
| 90648 |
|
130 |
130 |
$0.00 |
| 90710 |
|
12 |
12 |
$0.00 |
| 90707 |
|
12 |
12 |
$0.00 |