| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
7,301 |
6,382 |
$617K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,142 |
1,030 |
$140K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,509 |
1,421 |
$84K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,501 |
2,454 |
$49K |
| 92587 |
|
1,311 |
1,298 |
$41K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
289 |
289 |
$27K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
189 |
189 |
$18K |
| 96127 |
|
2,100 |
2,077 |
$15K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
90 |
90 |
$10K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,430 |
1,302 |
$8K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
195 |
186 |
$7K |
| 86580 |
|
1,151 |
1,132 |
$7K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
62 |
62 |
$7K |
| 81000 |
|
1,718 |
1,676 |
$6K |
| 99051 |
|
1,262 |
1,200 |
$5K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
122 |
121 |
$2K |
| 90461 |
|
200 |
199 |
$2K |
| 99382 |
|
13 |
13 |
$1K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
13 |
12 |
$1K |
| 99383 |
|
13 |
13 |
$1K |
| 90686 |
|
790 |
782 |
$993.18 |
| 0071A |
|
18 |
18 |
$745.92 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
71 |
71 |
$685.26 |
| 86317 |
|
42 |
42 |
$559.44 |
| 0001A |
|
13 |
13 |
$552.17 |
| A4206 |
Syringe with needle, sterile, 1 cc or less, each |
3,278 |
3,146 |
$508.79 |
| 99050 |
|
69 |
69 |
$306.61 |
| 99072 |
|
1,659 |
1,328 |
$191.25 |
| 96160 |
|
45 |
45 |
$122.93 |
| 99173 |
|
148 |
144 |
$120.71 |
| 90688 |
|
56 |
56 |
$20.95 |
| 99000 |
|
191 |
172 |
$0.00 |
| 90700 |
|
56 |
55 |
$0.00 |
| A4617 |
Mouth piece |
47 |
39 |
$0.00 |
| 90713 |
|
15 |
15 |
$0.00 |