| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,584 |
1,313 |
$126K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
413 |
341 |
$41K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
225 |
216 |
$6K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
75 |
64 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
142 |
72 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
39 |
39 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
138 |
126 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
25 |
25 |
$1K |
| 81000 |
|
74 |
74 |
$250.43 |
| 81002 |
|
13 |
12 |
$41.76 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
13 |
13 |
$0.00 |