| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99199 |
Unlisted special service, procedure or report |
13,202 |
8,507 |
$74K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
325 |
253 |
$27K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
430 |
338 |
$24K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
490 |
253 |
$7K |
| 99383 |
|
19 |
14 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
359 |
224 |
$2K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
73 |
52 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
19 |
15 |
$1K |
| 92551 |
|
276 |
219 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
13 |
12 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
106 |
40 |
$890.19 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
20 |
20 |
$848.20 |
| 96127 |
|
228 |
156 |
$622.95 |
| 90656 |
|
36 |
35 |
$369.54 |
| 99173 |
|
263 |
206 |
$330.26 |
| 90461 |
|
64 |
38 |
$232.04 |
| 94760 |
|
115 |
55 |
$31.05 |
| 90688 |
|
18 |
13 |
$0.00 |