| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,443 |
3,859 |
$296K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,704 |
2,330 |
$259K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
3,752 |
3,496 |
$231K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,577 |
1,506 |
$129K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,313 |
1,211 |
$98K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
671 |
632 |
$58K |
| 99215 |
Prolong outpt/office vis |
212 |
167 |
$25K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
91 |
90 |
$9K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,133 |
1,084 |
$8K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
533 |
493 |
$8K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
129 |
118 |
$5K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
116 |
110 |
$4K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
41 |
40 |
$1K |
| 96160 |
|
374 |
365 |
$855.60 |
| 87428 |
|
14 |
14 |
$704.30 |
| 90670 |
|
775 |
723 |
$621.56 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
33 |
31 |
$411.58 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
12 |
12 |
$285.36 |
| 96127 |
|
104 |
104 |
$269.96 |
| 99177 |
|
53 |
53 |
$150.00 |
| 85018 |
|
40 |
39 |
$106.44 |
| 90686 |
|
629 |
603 |
$101.99 |
| 90672 |
|
25 |
25 |
$26.88 |
| 90698 |
|
312 |
284 |
$0.00 |
| 90716 |
|
49 |
39 |
$0.00 |
| 90744 |
|
61 |
53 |
$0.00 |
| 90680 |
|
209 |
192 |
$0.00 |
| 90651 |
|
26 |
26 |
$0.00 |
| 90685 |
|
151 |
117 |
$0.00 |
| 90633 |
|
74 |
64 |
$0.00 |
| 5250F |
|
78 |
53 |
$0.00 |
| 90734 |
|
14 |
14 |
$0.00 |
| 90707 |
|
40 |
39 |
$0.00 |
| 99072 |
|
61 |
57 |
$0.00 |