| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
974 |
890 |
$34K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
388 |
359 |
$18K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
350 |
332 |
$11K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
459 |
441 |
$6K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
533 |
245 |
$6K |
| 87428 |
|
71 |
68 |
$5K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
27 |
27 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
240 |
109 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
14 |
14 |
$1K |
| 90461 |
|
38 |
26 |
$224.16 |
| 99000 |
|
17 |
17 |
$183.60 |
| 87807 |
|
12 |
12 |
$132.00 |
| 92552 |
|
123 |
123 |
$126.30 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
12 |
12 |
$97.68 |
| 99173 |
|
75 |
75 |
$0.00 |
| 90686 |
|
18 |
17 |
$0.00 |