| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
341 |
327 |
$28K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
411 |
399 |
$21K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
209 |
209 |
$19K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
149 |
148 |
$13K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
117 |
117 |
$10K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
60 |
59 |
$6K |
| 90686 |
|
166 |
164 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
42 |
41 |
$2K |
| 87428 |
|
21 |
21 |
$1K |
| 90670 |
|
84 |
84 |
$913.00 |
| 90648 |
|
73 |
73 |
$807.00 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
19 |
19 |
$614.88 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
20 |
20 |
$297.92 |
| 99173 |
|
159 |
159 |
$275.00 |
| 92551 |
|
186 |
186 |
$78.00 |
| 96160 |
|
103 |
103 |
$0.00 |
| 99177 |
|
27 |
27 |
$0.00 |
| 96127 |
|
103 |
103 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
69 |
69 |
$0.00 |
| 96161 |
|
28 |
28 |
$0.00 |