| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,863 |
1,456 |
$112K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
815 |
623 |
$48K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
582 |
440 |
$35K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
361 |
273 |
$26K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
223 |
193 |
$16K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
339 |
277 |
$13K |
| 99381 |
|
84 |
70 |
$6K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,109 |
737 |
$5K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
698 |
465 |
$3K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
147 |
131 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
15 |
15 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
193 |
160 |
$2K |
| 90461 |
|
72 |
48 |
$893.50 |
| 87807 |
|
102 |
82 |
$821.45 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
77 |
50 |
$652.84 |
| 87430 |
|
46 |
41 |
$615.43 |
| 90474 |
|
232 |
150 |
$601.35 |
| 99173 |
|
400 |
330 |
$542.90 |
| 90671 |
|
295 |
195 |
$389.00 |
| 87400 |
|
61 |
51 |
$350.10 |
| 99188 |
|
49 |
37 |
$258.02 |
| 36416 |
|
122 |
86 |
$245.37 |
| 85018 |
|
123 |
86 |
$193.98 |
| 90656 |
|
59 |
37 |
$181.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
15 |
12 |
$141.83 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
45 |
24 |
$132.97 |
| 90677 |
|
118 |
95 |
$125.00 |
| 90660 |
|
66 |
54 |
$109.00 |
| 96127 |
|
35 |
29 |
$88.07 |
| 90473 |
|
19 |
16 |
$77.45 |
| 81001 |
|
36 |
28 |
$25.18 |
| 90674 |
|
74 |
65 |
$10.00 |
| 90687 |
|
40 |
19 |
$10.00 |
| 90698 |
|
130 |
81 |
$5.00 |
| 90657 |
|
32 |
18 |
$3.92 |
| 90697 |
|
193 |
141 |
$0.00 |
| 90680 |
|
159 |
115 |
$0.00 |
| 90716 |
|
62 |
41 |
$0.00 |
| 90378 |
|
50 |
42 |
$0.00 |
| 90633 |
|
248 |
175 |
$0.00 |
| 90707 |
|
14 |
12 |
$0.00 |
| 90710 |
|
17 |
14 |
$0.00 |