| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,105 |
1,054 |
$86K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,026 |
854 |
$72K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
825 |
777 |
$70K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
5,141 |
2,416 |
$58K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
437 |
414 |
$40K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
1,050 |
945 |
$33K |
| 99429 |
|
634 |
597 |
$22K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
8,209 |
6,889 |
$22K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,653 |
1,219 |
$13K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,662 |
1,485 |
$6K |
| 90461 |
|
1,525 |
1,256 |
$5K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
685 |
619 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
2,073 |
961 |
$2K |
| 99381 |
|
13 |
12 |
$949.92 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
39 |
39 |
$300.28 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
583 |
523 |
$197.25 |
| 92551 |
|
1,902 |
1,776 |
$173.52 |
| 99215 |
Prolong outpt/office vis |
17 |
14 |
$89.52 |
| 87807 |
|
14 |
14 |
$48.40 |
| 90688 |
|
265 |
265 |
$20.41 |
| 90686 |
|
476 |
447 |
$19.80 |
| 99173 |
|
2,000 |
1,866 |
$0.00 |
| 90671 |
|
219 |
179 |
$0.00 |
| 90670 |
|
365 |
352 |
$0.00 |
| 90621 |
|
13 |
13 |
$0.00 |
| 90710 |
|
12 |
12 |
$0.00 |
| 90633 |
|
143 |
135 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
16 |
15 |
$0.00 |
| 90715 |
|
12 |
12 |
$0.00 |
| 90734 |
|
14 |
14 |
$0.00 |
| 96127 |
|
1,149 |
828 |
$0.00 |
| 90680 |
|
287 |
246 |
$0.00 |
| 90619 |
|
34 |
34 |
$0.00 |
| 90698 |
|
161 |
154 |
$0.00 |
| 90651 |
|
88 |
88 |
$0.00 |
| 90697 |
|
223 |
188 |
$0.00 |
| 90744 |
|
12 |
12 |
$0.00 |