| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
878 |
792 |
$59K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,275 |
1,155 |
$48K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
144 |
134 |
$8K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
26 |
26 |
$3K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
988 |
414 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
22 |
15 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
17 |
16 |
$2K |
| 90670 |
|
26 |
25 |
$0.00 |
| 99173 |
|
463 |
431 |
$0.00 |
| 90686 |
|
42 |
39 |
$0.00 |