| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,173 |
1,104 |
$114K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,118 |
1,033 |
$71K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
72 |
72 |
$7K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
62 |
62 |
$7K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
50 |
50 |
$5K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
14 |
14 |
$1K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
12 |
12 |
$803.62 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
27 |
27 |
$333.90 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
12 |
12 |
$132.00 |
| 92551 |
|
246 |
243 |
$51.20 |
| 99177 |
|
56 |
56 |
$33.00 |
| 96127 |
|
124 |
124 |
$25.60 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
267 |
226 |
$23.07 |
| 96160 |
|
124 |
123 |
$15.32 |
| 90680 |
|
284 |
269 |
$0.00 |
| 90651 |
|
229 |
224 |
$0.00 |
| 90723 |
|
323 |
307 |
$0.00 |
| 90677 |
|
250 |
227 |
$0.00 |
| 90656 |
|
33 |
33 |
$0.00 |
| 90696 |
|
12 |
12 |
$0.00 |
| 90686 |
|
413 |
409 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
59 |
58 |
$0.00 |
| 90619 |
|
107 |
106 |
$0.00 |
| G9920 |
Screening performed and negative |
437 |
398 |
$0.00 |
| 90670 |
|
248 |
248 |
$0.00 |
| 90648 |
|
506 |
485 |
$0.00 |
| 90715 |
|
25 |
24 |
$0.00 |
| 90633 |
|
115 |
115 |
$0.00 |
| 90710 |
|
14 |
14 |
$0.00 |
| 90661 |
|
112 |
111 |
$0.00 |