| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
380 |
378 |
$27K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
486 |
437 |
$23K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
487 |
451 |
$16K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,435 |
522 |
$11K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
95 |
93 |
$7K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
95 |
92 |
$4K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
409 |
307 |
$3K |
| 90461 |
|
368 |
312 |
$2K |
| S8301 |
Infection control supplies, not otherwise specified |
1,765 |
1,431 |
$2K |
| 99000 |
|
99 |
96 |
$916.51 |
| 83655 |
|
14 |
14 |
$146.90 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
19 |
19 |
$141.12 |
| 96160 |
|
380 |
369 |
$28.96 |
| 90686 |
|
162 |
155 |
$0.00 |
| 99174 |
|
69 |
67 |
$0.00 |
| 90680 |
|
25 |
24 |
$0.00 |
| 36416 |
|
27 |
24 |
$0.00 |
| 90698 |
|
25 |
24 |
$0.00 |
| 90670 |
|
83 |
81 |
$0.00 |
| 90633 |
|
15 |
14 |
$0.00 |