| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,486 |
2,765 |
$181K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,362 |
1,102 |
$113K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
703 |
609 |
$65K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
624 |
582 |
$57K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
448 |
441 |
$49K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,375 |
1,924 |
$13K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
60 |
55 |
$6K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,618 |
874 |
$4K |
| 90686 |
|
956 |
670 |
$3K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
228 |
104 |
$2K |
| 91300 |
|
64 |
61 |
$935.60 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
33 |
31 |
$775.30 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
99 |
95 |
$313.23 |
| 0001A |
|
14 |
14 |
$116.67 |
| 96127 |
|
250 |
241 |
$50.00 |
| 90656 |
|
79 |
78 |
$42.76 |
| 87400 |
|
26 |
13 |
$0.00 |
| 90734 |
|
12 |
12 |
$0.00 |
| 90707 |
|
13 |
13 |
$0.00 |
| 90619 |
|
14 |
14 |
$0.00 |
| S8301 |
Infection control supplies, not otherwise specified |
26 |
26 |
$0.00 |
| 91307 |
|
22 |
13 |
$0.00 |