| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,260 |
3,861 |
$242K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
680 |
680 |
$52K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,480 |
2,469 |
$50K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
505 |
501 |
$43K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
445 |
445 |
$34K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
319 |
319 |
$26K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
403 |
384 |
$15K |
| 97802 |
|
2,867 |
2,815 |
$2K |
| 90480 |
|
53 |
53 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
22 |
22 |
$826.61 |
| 0071A |
|
17 |
17 |
$634.37 |
| 0072A |
|
16 |
16 |
$586.40 |
| 96127 |
|
120 |
120 |
$451.58 |
| 99429 |
|
34 |
34 |
$147.50 |
| 90686 |
|
1,214 |
1,214 |
$142.01 |
| 90656 |
|
35 |
35 |
$101.73 |
| 99072 |
|
870 |
819 |
$0.43 |
| 99080 |
|
133 |
133 |
$0.00 |
| 90685 |
|
14 |
13 |
$0.00 |
| 90461 |
|
27 |
27 |
$0.00 |
| 91321 |
|
12 |
12 |
$0.00 |
| 91307 |
|
43 |
38 |
$0.00 |