| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,879 |
6,094 |
$263K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,489 |
1,378 |
$80K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
5,114 |
2,021 |
$71K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
789 |
782 |
$65K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
815 |
807 |
$64K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
293 |
291 |
$26K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,378 |
647 |
$19K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
458 |
430 |
$19K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,025 |
945 |
$15K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
69 |
69 |
$7K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
666 |
636 |
$6K |
| 90461 |
|
2,133 |
602 |
$2K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
110 |
102 |
$1K |
| 99381 |
|
14 |
13 |
$1K |
| 96380 |
|
12 |
12 |
$244.81 |
| 87807 |
|
12 |
12 |
$137.30 |
| 96160 |
|
75 |
75 |
$135.99 |
| 90688 |
|
198 |
192 |
$1.15 |
| 90671 |
|
389 |
387 |
$0.60 |
| 90697 |
|
50 |
48 |
$0.10 |
| 90381 |
|
17 |
17 |
$0.01 |
| 90687 |
|
82 |
81 |
$0.00 |
| 90670 |
|
292 |
288 |
$0.00 |
| 90648 |
|
79 |
77 |
$0.00 |
| 99173 |
|
520 |
513 |
$0.00 |
| 90633 |
|
178 |
178 |
$0.00 |
| 90707 |
|
103 |
102 |
$0.00 |
| 90700 |
|
51 |
51 |
$0.00 |
| 90744 |
|
185 |
184 |
$0.00 |
| 90698 |
|
352 |
351 |
$0.00 |
| 90680 |
|
506 |
502 |
$0.00 |
| 90716 |
|
103 |
102 |
$0.00 |
| 96127 |
|
68 |
66 |
$0.00 |
| 90723 |
|
19 |
18 |
$0.00 |
| 90656 |
|
20 |
20 |
$0.00 |