| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,231 |
4,597 |
$229K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,073 |
2,750 |
$113K |
| 90674 |
|
308 |
297 |
$5K |
| 90686 |
|
549 |
507 |
$5K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
377 |
345 |
$3K |
| 96127 |
|
913 |
786 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
26 |
26 |
$2K |
| 0011A |
|
38 |
38 |
$2K |
| 0064A |
|
35 |
30 |
$1K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
38 |
32 |
$1K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
14 |
14 |
$1K |
| 0012A |
|
25 |
25 |
$1K |
| 99215 |
Prolong outpt/office vis |
17 |
14 |
$833.55 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
226 |
208 |
$785.46 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12 |
12 |
$738.00 |
| 99499 |
|
42 |
42 |
$736.50 |
| 99429 |
|
43 |
43 |
$717.08 |
| 99173 |
|
447 |
429 |
$543.73 |
| 99072 |
|
2,635 |
2,135 |
$510.00 |
| 87428 |
|
15 |
15 |
$462.96 |
| 0124A |
|
12 |
12 |
$360.00 |
| 90688 |
|
13 |
13 |
$77.48 |
| 91307 |
|
14 |
12 |
$0.00 |
| 91306 |
|
36 |
31 |
$0.00 |
| 91301 |
|
91 |
86 |
$0.00 |