| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,068 |
5,194 |
$220K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
836 |
831 |
$71K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
641 |
633 |
$57K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
591 |
585 |
$48K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
1,142 |
1,084 |
$47K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
4,167 |
1,766 |
$46K |
| 99429 |
|
507 |
505 |
$18K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,278 |
1,180 |
$17K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,217 |
581 |
$17K |
| 87428 |
|
149 |
144 |
$11K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
210 |
205 |
$10K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
107 |
107 |
$10K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
973 |
968 |
$9K |
| 92552 |
|
1,079 |
1,071 |
$8K |
| 87400 |
|
593 |
277 |
$7K |
| 90461 |
|
641 |
536 |
$4K |
| 92551 |
|
182 |
182 |
$1K |
| 99381 |
|
13 |
12 |
$731.02 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
33 |
33 |
$401.25 |
| 87807 |
|
18 |
18 |
$202.71 |
| 96160 |
|
73 |
73 |
$167.42 |
| 90686 |
|
558 |
554 |
$0.00 |
| 90680 |
|
206 |
205 |
$0.00 |
| 96127 |
|
375 |
374 |
$0.00 |
| 90697 |
|
65 |
65 |
$0.00 |
| 90698 |
|
74 |
73 |
$0.00 |
| 90656 |
|
39 |
39 |
$0.00 |
| 90744 |
|
13 |
13 |
$0.00 |
| 90651 |
|
12 |
12 |
$0.00 |
| 99173 |
|
1,290 |
1,279 |
$0.00 |
| 90670 |
|
369 |
368 |
$0.00 |
| 90671 |
|
44 |
43 |
$0.00 |
| 90633 |
|
62 |
62 |
$0.00 |