| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,834 |
2,167 |
$79K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
202 |
188 |
$13K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
414 |
341 |
$11K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
128 |
121 |
$9K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
748 |
444 |
$8K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
61 |
58 |
$4K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
246 |
234 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
26 |
25 |
$2K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
169 |
155 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
120 |
110 |
$1K |
| 99441 |
|
102 |
85 |
$1K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
116 |
92 |
$872.50 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
149 |
123 |
$704.37 |
| 81003 |
|
543 |
328 |
$638.28 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
16 |
15 |
$333.17 |
| 87428 |
|
16 |
16 |
$330.44 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
36 |
35 |
$305.32 |
| 90461 |
|
125 |
108 |
$81.93 |
| 90686 |
|
17 |
13 |
$57.78 |
| 90677 |
|
74 |
68 |
$0.09 |
| 90697 |
|
12 |
12 |
$0.01 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
93 |
74 |
$0.00 |
| 90698 |
|
17 |
13 |
$0.00 |
| 90680 |
|
12 |
12 |
$0.00 |
| 90656 |
|
13 |
12 |
$0.00 |
| 90681 |
|
20 |
17 |
$0.00 |
| T1015 |
Clinic visit/encounter, all-inclusive |
35 |
32 |
$0.00 |
| 90670 |
|
38 |
34 |
$0.00 |
| 90687 |
|
14 |
12 |
$0.00 |