| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
7,434 |
6,415 |
$298K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,149 |
1,138 |
$113K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,035 |
1,028 |
$94K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
4,572 |
2,782 |
$46K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
258 |
255 |
$22K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
247 |
235 |
$11K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
559 |
251 |
$8K |
| S8301 |
Infection control supplies, not otherwise specified |
329 |
308 |
$4K |
| 90461 |
|
721 |
578 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
57 |
52 |
$3K |
| 97169 |
|
86 |
85 |
$2K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
14 |
13 |
$1K |
| 92551 |
|
2,849 |
2,810 |
$230.00 |
| 90686 |
|
1,383 |
1,377 |
$43.00 |
| 90651 |
|
372 |
367 |
$15.00 |
| 90734 |
|
218 |
214 |
$8.00 |
| 99173 |
|
2,629 |
2,604 |
$0.00 |
| 90715 |
|
30 |
28 |
$0.00 |