| Code | Description | Claims | Beneficiaries | Total Paid |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
15,481 |
13,851 |
$515K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,880 |
1,844 |
$136K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,826 |
1,790 |
$135K |
| 87428 |
|
1,179 |
1,143 |
$58K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,018 |
931 |
$50K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
5,579 |
3,121 |
$50K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
4,625 |
4,536 |
$49K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
645 |
607 |
$31K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
401 |
389 |
$31K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,076 |
1,024 |
$14K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
764 |
361 |
$10K |
| 87420 |
|
701 |
681 |
$8K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
87 |
84 |
$7K |
| 90474 |
|
529 |
518 |
$5K |
| 87081 |
|
841 |
803 |
$4K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
32 |
32 |
$980.11 |
| 99381 |
|
12 |
12 |
$879.69 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
78 |
68 |
$641.97 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
13 |
13 |
$86.87 |
| 85027 |
|
12 |
12 |
$65.16 |
| 85007 |
|
12 |
12 |
$38.28 |
| 90671 |
|
571 |
565 |
$1.87 |
| 90697 |
|
19 |
16 |
$0.03 |
| 90686 |
|
690 |
671 |
$0.03 |
| 90710 |
|
66 |
65 |
$0.00 |
| 90670 |
|
998 |
985 |
$0.00 |
| 90648 |
|
881 |
870 |
$0.00 |
| 90633 |
|
278 |
275 |
$0.00 |
| 90681 |
|
89 |
89 |
$0.00 |
| 90734 |
|
13 |
13 |
$0.00 |
| 90723 |
|
513 |
505 |
$0.00 |
| 90680 |
|
345 |
338 |
$0.00 |
| 90698 |
|
12 |
12 |
$0.00 |
| 90656 |
|
34 |
34 |
$0.00 |