| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,547 |
3,279 |
$197K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
659 |
628 |
$49K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
343 |
343 |
$40K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
127 |
121 |
$12K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
836 |
817 |
$11K |
| 92552 |
|
644 |
626 |
$6K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
29 |
25 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
13 |
13 |
$1K |
| 90461 |
|
224 |
219 |
$804.00 |
| 90686 |
|
68 |
67 |
$694.21 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
105 |
57 |
$657.10 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
40 |
40 |
$293.25 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
14 |
14 |
$89.47 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
33 |
32 |
$20.00 |
| 99173 |
|
635 |
618 |
$3.26 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
24 |
24 |
$0.00 |