| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
476 |
364 |
$13K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
165 |
118 |
$5K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
346 |
107 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
20 |
18 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
33 |
24 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
22 |
12 |
$840.40 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
18 |
12 |
$566.52 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
36 |
12 |
$333.60 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
12 |
12 |
$318.48 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
31 |
24 |
$166.68 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
66 |
26 |
$152.66 |
| 96127 |
|
59 |
44 |
$0.00 |
| 99173 |
|
29 |
15 |
$0.00 |