| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
705 |
682 |
$56K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
661 |
612 |
$32K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
210 |
210 |
$15K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
61 |
61 |
$6K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
56 |
54 |
$5K |
| 87428 |
|
57 |
57 |
$3K |
| 90686 |
|
231 |
227 |
$3K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
69 |
67 |
$2K |
| 99215 |
Prolong outpt/office vis |
14 |
12 |
$2K |
| 99051 |
|
59 |
59 |
$2K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
27 |
27 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
28 |
14 |
$358.50 |
| 90648 |
|
14 |
14 |
$170.04 |
| 90670 |
|
14 |
14 |
$154.00 |
| 92551 |
|
99 |
99 |
$52.00 |
| 99177 |
|
51 |
51 |
$21.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
113 |
113 |
$19.25 |
| 96127 |
|
55 |
55 |
$12.32 |
| 96160 |
|
55 |
55 |
$10.72 |
| G9920 |
Screening performed and negative |
81 |
81 |
$0.00 |