| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,528 |
1,474 |
$110K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
594 |
568 |
$27K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
72 |
72 |
$6K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
73 |
72 |
$6K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
197 |
190 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
17 |
17 |
$2K |
| 87428 |
|
63 |
62 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
12 |
12 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
98 |
48 |
$1K |
| 90686 |
|
172 |
172 |
$554.00 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
16 |
16 |
$538.02 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
12 |
12 |
$293.67 |
| 92551 |
|
204 |
203 |
$111.74 |
| 99177 |
|
125 |
124 |
$81.50 |
| 96127 |
|
65 |
65 |
$30.80 |
| 96160 |
|
65 |
65 |
$26.80 |
| G9920 |
Screening performed and negative |
68 |
68 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
31 |
30 |
$0.00 |