| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
3,114 |
2,615 |
$213K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,068 |
3,634 |
$193K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,509 |
2,008 |
$191K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
3,099 |
2,655 |
$59K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
767 |
698 |
$57K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
762 |
705 |
$57K |
| 90670 |
|
2,089 |
1,676 |
$37K |
| 90677 |
|
538 |
496 |
$26K |
| 96127 |
|
1,620 |
1,492 |
$25K |
| 90723 |
|
1,620 |
1,295 |
$19K |
| 90647 |
|
1,592 |
1,295 |
$19K |
| 90680 |
|
1,410 |
1,122 |
$17K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
200 |
174 |
$16K |
| 90686 |
|
1,439 |
1,220 |
$14K |
| 83655 |
|
1,041 |
830 |
$12K |
| 90633 |
|
926 |
738 |
$10K |
| 99381 |
|
95 |
90 |
$8K |
| 90698 |
|
565 |
461 |
$5K |
| 90651 |
|
106 |
83 |
$4K |
| 85018 |
|
1,031 |
824 |
$2K |
| 96160 |
|
133 |
125 |
$2K |
| 90656 |
|
107 |
105 |
$2K |
| 90716 |
|
107 |
84 |
$2K |
| 90744 |
|
215 |
195 |
$1K |
| 90707 |
|
105 |
77 |
$1K |
| 90681 |
|
117 |
101 |
$1K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
71 |
64 |
$873.36 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
18 |
17 |
$635.94 |
| 90700 |
|
43 |
40 |
$521.60 |
| 90381 |
|
16 |
16 |
$267.36 |
| 90734 |
|
15 |
15 |
$250.65 |
| 90710 |
|
12 |
12 |
$200.52 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
15 |
13 |
$86.10 |
| 90696 |
|
13 |
13 |
$83.20 |
| 90461 |
|
37 |
32 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
68 |
60 |
$0.00 |