| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,222 |
892 |
$44K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
562 |
454 |
$18K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
189 |
148 |
$10K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
400 |
347 |
$6K |
| 92552 |
|
284 |
231 |
$5K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
71 |
59 |
$5K |
| 99177 |
|
500 |
400 |
$3K |
| 87428 |
|
31 |
28 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
20 |
14 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$985.80 |
| 96127 |
|
196 |
165 |
$751.49 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
21 |
18 |
$700.54 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
128 |
27 |
$658.62 |
| 90686 |
|
254 |
185 |
$320.68 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
35 |
29 |
$310.22 |
| 90661 |
|
13 |
13 |
$0.00 |