| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
392 |
331 |
$35K |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
122 |
122 |
$15K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
108 |
106 |
$6K |
| 92552 |
|
111 |
111 |
$4K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
160 |
153 |
$4K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
34 |
34 |
$4K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
29 |
29 |
$3K |
| 92567 |
|
136 |
119 |
$2K |
| 94010 |
|
51 |
50 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
13 |
13 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
68 |
60 |
$1K |
| 86580 |
|
110 |
110 |
$905.30 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
16 |
13 |
$565.28 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
32 |
13 |
$529.60 |
| 81000 |
|
32 |
32 |
$128.64 |