| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,488 |
2,277 |
$169K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
405 |
377 |
$41K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,733 |
1,572 |
$36K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
386 |
372 |
$36K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
212 |
204 |
$19K |
| 90461 |
|
631 |
466 |
$17K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
66 |
66 |
$6K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
110 |
110 |
$4K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
286 |
161 |
$4K |
| 99050 |
|
93 |
89 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
167 |
165 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
113 |
111 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
27 |
26 |
$950.85 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
68 |
53 |
$746.26 |
| 0071A |
|
15 |
15 |
$624.45 |
| 87807 |
|
61 |
61 |
$592.73 |
| 96161 |
|
101 |
96 |
$348.12 |
| 90473 |
|
17 |
17 |
$199.44 |
| 90686 |
|
192 |
180 |
$93.00 |
| 96127 |
|
29 |
26 |
$91.18 |
| 96160 |
|
26 |
25 |
$90.01 |
| 90674 |
|
19 |
19 |
$9.50 |
| 90672 |
|
16 |
16 |
$8.00 |
| 90656 |
|
13 |
13 |
$6.50 |