| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,742 |
4,800 |
$267K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,437 |
1,078 |
$98K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
671 |
523 |
$51K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
2,507 |
2,100 |
$40K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
310 |
264 |
$23K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
251 |
211 |
$19K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
464 |
435 |
$16K |
| 90670 |
|
588 |
421 |
$12K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
117 |
107 |
$10K |
| 87428 |
|
113 |
106 |
$7K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
367 |
168 |
$6K |
| 96127 |
|
274 |
231 |
$4K |
| 90698 |
|
285 |
213 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
173 |
165 |
$3K |
| 90677 |
|
26 |
25 |
$2K |
| 90680 |
|
132 |
102 |
$2K |
| 87807 |
|
90 |
83 |
$883.28 |
| 90686 |
|
40 |
29 |
$379.72 |
| 90744 |
|
12 |
12 |
$259.78 |
| 81002 |
|
85 |
72 |
$221.00 |
| 90461 |
|
27 |
17 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
187 |
79 |
$0.00 |