| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,406 |
1,220 |
$64K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,185 |
1,054 |
$39K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
317 |
311 |
$24K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
294 |
281 |
$23K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,433 |
612 |
$18K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
316 |
308 |
$13K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
146 |
142 |
$13K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,011 |
469 |
$12K |
| 99429 |
|
361 |
339 |
$12K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
88 |
84 |
$7K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
747 |
619 |
$6K |
| 87430 |
|
391 |
368 |
$5K |
| 99381 |
|
57 |
54 |
$4K |
| 99383 |
|
26 |
25 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
13 |
13 |
$1K |
| 99382 |
|
13 |
12 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
16 |
15 |
$950.14 |
| 87807 |
|
87 |
81 |
$726.00 |
| 69210 |
|
13 |
13 |
$429.11 |
| 96380 |
|
15 |
15 |
$286.35 |
| 96160 |
|
28 |
27 |
$58.50 |
| 90677 |
|
241 |
236 |
$0.30 |
| 90697 |
|
107 |
106 |
$0.14 |
| 90648 |
|
12 |
12 |
$0.00 |
| 90633 |
|
26 |
25 |
$0.00 |
| 90680 |
|
171 |
168 |
$0.00 |
| 90686 |
|
190 |
184 |
$0.00 |