| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,927 |
2,649 |
$265K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,047 |
1,026 |
$111K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
844 |
779 |
$84K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
568 |
561 |
$61K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
354 |
347 |
$41K |
| 87428 |
|
553 |
521 |
$31K |
| 90461 |
|
624 |
609 |
$21K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,107 |
1,083 |
$18K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
573 |
553 |
$9K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
743 |
715 |
$7K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
461 |
455 |
$6K |
| 99051 |
|
115 |
112 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
12 |
12 |
$2K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
28 |
24 |
$1K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
32 |
32 |
$999.28 |
| 99460 |
|
20 |
15 |
$870.44 |
| 90473 |
|
75 |
73 |
$842.92 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
22 |
22 |
$208.04 |
| 88720 |
|
17 |
12 |
$66.60 |
| 90656 |
|
35 |
35 |
$0.28 |
| 90686 |
|
13 |
12 |
$0.11 |