| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
10,108 |
8,067 |
$371K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,279 |
1,272 |
$101K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
935 |
931 |
$78K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
881 |
871 |
$77K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
934 |
926 |
$71K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
5,375 |
2,492 |
$58K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
516 |
495 |
$26K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
622 |
552 |
$25K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,766 |
840 |
$23K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,034 |
976 |
$14K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
134 |
132 |
$8K |
| 99429 |
|
219 |
219 |
$7K |
| 90461 |
|
1,730 |
1,414 |
$7K |
| 99050 |
|
260 |
237 |
$3K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
288 |
206 |
$2K |
| 87807 |
|
233 |
223 |
$2K |
| 92551 |
|
415 |
407 |
$2K |
| 97169 |
|
12 |
12 |
$450.00 |
| 99381 |
|
13 |
12 |
$422.55 |
| 96160 |
|
257 |
254 |
$297.00 |
| 99051 |
|
98 |
91 |
$44.82 |
| 90677 |
|
147 |
147 |
$0.12 |
| 90734 |
|
56 |
55 |
$0.00 |
| 90715 |
|
13 |
13 |
$0.00 |
| 99173 |
|
412 |
405 |
$0.00 |
| 90670 |
|
674 |
664 |
$0.00 |
| 90633 |
|
186 |
186 |
$0.00 |
| 90648 |
|
261 |
257 |
$0.00 |
| 99080 |
|
27 |
27 |
$0.00 |
| 90621 |
|
15 |
15 |
$0.00 |
| 90672 |
|
26 |
25 |
$0.00 |
| 90681 |
|
77 |
76 |
$0.00 |
| 90651 |
|
78 |
78 |
$0.00 |
| 90686 |
|
229 |
228 |
$0.00 |
| 90723 |
|
44 |
43 |
$0.00 |
| 90656 |
|
72 |
72 |
$0.00 |