| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,064 |
1,874 |
$182K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
958 |
943 |
$103K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
614 |
608 |
$66K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
694 |
615 |
$63K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
268 |
239 |
$28K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
2,000 |
1,889 |
$16K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
105 |
102 |
$12K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
195 |
179 |
$9K |
| 90686 |
|
226 |
216 |
$5K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
398 |
363 |
$4K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
58 |
56 |
$3K |
| 90656 |
|
38 |
38 |
$876.26 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
24 |
12 |
$500.08 |
| 0072A |
|
12 |
12 |
$480.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
309 |
291 |
$445.88 |
| 0071A |
|
16 |
16 |
$400.00 |
| 90670 |
|
13 |
13 |
$302.64 |
| 91307 |
|
28 |
23 |
$0.00 |