| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
365 |
333 |
$25K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
84 |
79 |
$8K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
113 |
113 |
$7K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
61 |
61 |
$6K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
142 |
142 |
$6K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
25 |
25 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
28 |
28 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
24 |
24 |
$2K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
48 |
47 |
$2K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
47 |
44 |
$449.42 |
| 87807 |
|
32 |
32 |
$437.32 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
18 |
18 |
$271.44 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
19 |
19 |
$223.63 |
| 87070 |
|
18 |
18 |
$194.94 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
221 |
213 |
$0.00 |
| 90647 |
|
38 |
38 |
$0.00 |
| 90716 |
|
12 |
12 |
$0.00 |
| 90723 |
|
36 |
36 |
$0.00 |
| 90670 |
|
46 |
46 |
$0.00 |
| 90707 |
|
12 |
12 |
$0.00 |
| 90681 |
|
19 |
19 |
$0.00 |
| 90633 |
|
14 |
14 |
$0.00 |