| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,350 |
1,101 |
$89K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,346 |
1,081 |
$32K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
36 |
28 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
27 |
24 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
15 |
13 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
17 |
13 |
$1K |
| 99173 |
|
201 |
162 |
$1K |
| 87428 |
|
14 |
13 |
$763.08 |
| 96127 |
|
29 |
27 |
$513.36 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
16 |
13 |
$353.30 |
| 90686 |
|
657 |
581 |
$38.06 |
| 90661 |
|
15 |
14 |
$0.00 |
| 90674 |
|
103 |
89 |
$0.00 |