| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,001 |
4,560 |
$191K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,211 |
1,135 |
$65K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
629 |
622 |
$56K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
610 |
596 |
$50K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
339 |
335 |
$33K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
3,193 |
1,400 |
$32K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
277 |
275 |
$22K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
404 |
392 |
$11K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
464 |
454 |
$7K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
351 |
171 |
$5K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
93 |
93 |
$5K |
| 90461 |
|
641 |
512 |
$4K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
243 |
205 |
$2K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
173 |
132 |
$976.30 |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
15 |
15 |
$468.75 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
30 |
29 |
$224.86 |
| 97802 |
|
572 |
563 |
$2.92 |
| 90686 |
|
201 |
172 |
$0.01 |
| 90734 |
|
46 |
46 |
$0.01 |
| 90647 |
|
39 |
38 |
$0.00 |
| 90716 |
|
39 |
39 |
$0.00 |
| 90723 |
|
25 |
24 |
$0.00 |
| 90680 |
|
26 |
25 |
$0.00 |
| 90651 |
|
12 |
12 |
$0.00 |
| 3210F |
|
417 |
409 |
$0.00 |
| 90670 |
|
255 |
246 |
$0.00 |
| 90715 |
|
37 |
37 |
$0.00 |
| 90710 |
|
31 |
28 |
$0.00 |
| 99177 |
|
40 |
39 |
$0.00 |
| 90707 |
|
27 |
27 |
$0.00 |