| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,174 |
1,094 |
$58K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
637 |
579 |
$46K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
741 |
530 |
$16K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
171 |
152 |
$13K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
147 |
110 |
$11K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
170 |
158 |
$8K |
| 90686 |
|
288 |
256 |
$3K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
48 |
43 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
33 |
26 |
$2K |
| 90656 |
|
49 |
48 |
$817.71 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
64 |
63 |
$798.56 |
| 87430 |
|
41 |
39 |
$565.49 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
15 |
14 |
$323.45 |
| 90670 |
|
15 |
14 |
$250.65 |
| 90697 |
|
12 |
12 |
$200.52 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
445 |
376 |
$179.74 |
| 96127 |
|
13 |
13 |
$150.00 |
| 90461 |
|
86 |
82 |
$0.00 |
| 99072 |
|
12 |
12 |
$0.00 |