| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,583 |
3,509 |
$301K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,001 |
769 |
$79K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
867 |
721 |
$74K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
532 |
451 |
$46K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
363 |
314 |
$31K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
2,596 |
2,146 |
$21K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,274 |
850 |
$20K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
481 |
396 |
$16K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
2,062 |
1,652 |
$15K |
| 90670 |
|
536 |
435 |
$10K |
| 94760 |
|
7,218 |
5,513 |
$8K |
| 90686 |
|
442 |
358 |
$7K |
| 90697 |
|
236 |
173 |
$6K |
| 92551 |
|
725 |
547 |
$5K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
604 |
270 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
70 |
44 |
$5K |
| 90680 |
|
244 |
199 |
$4K |
| 86580 |
|
685 |
440 |
$3K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
136 |
44 |
$2K |
| 90633 |
|
168 |
110 |
$2K |
| 99173 |
|
882 |
690 |
$2K |
| 90685 |
|
94 |
85 |
$2K |
| 90710 |
|
78 |
57 |
$1K |
| 90651 |
|
87 |
59 |
$1K |
| 90656 |
|
32 |
32 |
$704.74 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
67 |
46 |
$677.88 |
| 90696 |
|
37 |
25 |
$526.97 |
| 0071A |
|
19 |
13 |
$520.00 |
| 87807 |
|
48 |
46 |
$494.15 |
| 90698 |
|
12 |
12 |
$254.87 |
| 90480 |
|
20 |
14 |
$244.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
3,417 |
2,041 |
$60.00 |
| 91307 |
|
24 |
17 |
$0.02 |
| D1206 |
Topical application of fluoride varnish |
52 |
39 |
$0.00 |