| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,512 |
2,246 |
$193K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,185 |
1,088 |
$132K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
301 |
295 |
$45K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
320 |
315 |
$43K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
166 |
162 |
$24K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
122 |
118 |
$19K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,052 |
1,029 |
$7K |
| 92552 |
|
731 |
721 |
$3K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
29 |
29 |
$811.16 |
| 0072A |
|
14 |
14 |
$492.76 |
| 99188 |
|
44 |
44 |
$192.84 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
58 |
54 |
$162.03 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
18 |
18 |
$64.88 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
80 |
76 |
$57.21 |
| 90686 |
|
48 |
46 |
$10.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
92 |
80 |
$0.00 |
| 99173 |
|
246 |
239 |
$0.00 |
| 90633 |
|
14 |
14 |
$0.00 |