| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,429 |
3,189 |
$130K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,424 |
1,226 |
$113K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,223 |
1,218 |
$103K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
5,720 |
2,430 |
$62K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
602 |
600 |
$53K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
707 |
673 |
$37K |
| 99460 |
|
216 |
215 |
$15K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,220 |
1,027 |
$10K |
| 90461 |
|
1,648 |
1,424 |
$10K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
81 |
81 |
$8K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
85 |
83 |
$5K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
170 |
168 |
$4K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
78 |
77 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
161 |
151 |
$2K |
| 99462 |
|
12 |
12 |
$485.24 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
12 |
12 |
$405.43 |
| 92551 |
|
84 |
83 |
$103.55 |
| 90686 |
|
753 |
749 |
$35.00 |
| 90677 |
|
82 |
79 |
$20.06 |
| 90680 |
|
474 |
473 |
$0.00 |
| 90698 |
|
552 |
548 |
$0.00 |
| 90656 |
|
113 |
113 |
$0.00 |
| 90723 |
|
130 |
129 |
$0.00 |
| 90696 |
|
15 |
15 |
$0.00 |
| 90744 |
|
12 |
12 |
$0.00 |
| 90716 |
|
14 |
14 |
$0.00 |
| 90670 |
|
766 |
765 |
$0.00 |
| 99173 |
|
100 |
97 |
$0.00 |
| 90633 |
|
215 |
214 |
$0.00 |
| 90648 |
|
124 |
123 |
$0.00 |
| 90707 |
|
13 |
13 |
$0.00 |
| 90710 |
|
14 |
14 |
$0.00 |