| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,207 |
1,157 |
$95K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
229 |
218 |
$26K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
533 |
527 |
$20K |
| 87428 |
|
77 |
76 |
$4K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
57 |
57 |
$4K |
| 90461 |
|
56 |
55 |
$2K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
27 |
26 |
$734.76 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
12 |
12 |
$493.79 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
48 |
47 |
$465.70 |
| 99177 |
|
92 |
92 |
$440.55 |
| 99173 |
|
40 |
40 |
$45.64 |
| 90674 |
|
60 |
59 |
$34.18 |
| 90661 |
|
21 |
21 |
$25.04 |