| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,589 |
1,283 |
$174K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,001 |
740 |
$65K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
99 |
79 |
$4K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
24 |
24 |
$2K |
| 90688 |
|
86 |
79 |
$2K |
| 90686 |
|
82 |
74 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
555 |
389 |
$907.92 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
15 |
15 |
$742.08 |
| 90658 |
|
12 |
12 |
$209.52 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
18 |
15 |
$149.68 |
| 91307 |
|
15 |
15 |
$0.00 |