| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,873 |
1,628 |
$137K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
994 |
882 |
$104K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
317 |
286 |
$30K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
274 |
239 |
$28K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
286 |
263 |
$27K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
448 |
376 |
$14K |
| 92551 |
|
1,226 |
1,120 |
$11K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,250 |
1,074 |
$10K |
| 90686 |
|
264 |
243 |
$5K |
| 96127 |
|
757 |
597 |
$3K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
640 |
535 |
$3K |
| 99173 |
|
1,184 |
1,085 |
$3K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
28 |
26 |
$2K |
| 81002 |
|
763 |
697 |
$2K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
93 |
76 |
$1K |
| 90656 |
|
40 |
39 |
$881.14 |
| 90480 |
|
19 |
17 |
$512.08 |
| 0072A |
|
21 |
15 |
$480.00 |
| 99177 |
|
119 |
111 |
$419.53 |
| 90651 |
|
15 |
15 |
$256.08 |
| 90670 |
|
14 |
13 |
$232.80 |
| 90698 |
|
13 |
12 |
$232.80 |
| 90461 |
|
31 |
28 |
$192.50 |
| 90688 |
|
38 |
31 |
$186.24 |
| 96160 |
|
16 |
12 |
$28.54 |
| 99188 |
|
16 |
12 |
$6.00 |
| 91307 |
|
64 |
38 |
$0.00 |
| 81001 |
|
28 |
25 |
$0.00 |