| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,939 |
2,637 |
$140K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,885 |
1,667 |
$129K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,205 |
1,121 |
$78K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
3,382 |
3,080 |
$45K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
754 |
692 |
$43K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
631 |
569 |
$40K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,327 |
1,199 |
$36K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,975 |
1,768 |
$32K |
| 92551 |
|
1,742 |
1,616 |
$13K |
| 85018 |
|
2,948 |
2,491 |
$6K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
55 |
55 |
$4K |
| 81003 |
|
2,223 |
1,855 |
$4K |
| 99173 |
|
1,972 |
1,780 |
$3K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
378 |
281 |
$3K |
| 0072A |
|
31 |
31 |
$2K |
| 0071A |
|
136 |
33 |
$1K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
30 |
27 |
$838.08 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
28 |
14 |
$367.64 |
| 90474 |
|
51 |
41 |
$365.20 |
| 90473 |
|
30 |
28 |
$292.04 |
| 96160 |
|
100 |
91 |
$204.38 |
| 96161 |
|
31 |
28 |
$122.10 |
| 3008F |
|
2,406 |
2,156 |
$0.00 |
| 90698 |
|
123 |
116 |
$0.00 |
| 90686 |
|
1,625 |
1,457 |
$0.00 |
| 90680 |
|
182 |
157 |
$0.00 |
| 91307 |
|
134 |
64 |
$0.00 |
| 90744 |
|
27 |
26 |
$0.00 |
| 90656 |
|
27 |
23 |
$0.00 |
| 90670 |
|
409 |
376 |
$0.00 |
| 90671 |
|
134 |
112 |
$0.00 |
| 90685 |
|
60 |
57 |
$0.00 |
| 90633 |
|
74 |
62 |
$0.00 |
| 90661 |
|
20 |
19 |
$0.00 |
| 99072 |
|
25 |
15 |
$0.00 |