| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
768 |
675 |
$27K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
71 |
70 |
$6K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
51 |
51 |
$4K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
98 |
92 |
$4K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
505 |
219 |
$4K |
| 87428 |
|
48 |
45 |
$3K |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
198 |
177 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
13 |
13 |
$1K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
13 |
13 |
$1K |
| 90461 |
|
121 |
94 |
$879.72 |
| 99001 |
|
160 |
147 |
$760.59 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
75 |
73 |
$585.64 |
| 96160 |
|
122 |
116 |
$312.14 |
| 92587 |
|
68 |
67 |
$124.14 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
12 |
12 |
$15.39 |
| 90686 |
|
83 |
79 |
$0.00 |
| 90716 |
|
12 |
12 |
$0.00 |
| 97803 |
|
33 |
33 |
$0.00 |
| 99173 |
|
100 |
99 |
$0.00 |
| 90670 |
|
13 |
13 |
$0.00 |