| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,735 |
2,610 |
$108K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
749 |
731 |
$43K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,582 |
1,505 |
$31K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
338 |
338 |
$23K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
199 |
198 |
$13K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
156 |
156 |
$11K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
24 |
24 |
$1K |
| 90619 |
|
13 |
13 |
$980.00 |
| 96127 |
|
249 |
246 |
$728.04 |
| 97803 |
|
151 |
151 |
$663.53 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
13 |
13 |
$547.70 |
| 99173 |
|
1,110 |
1,110 |
$507.34 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
38 |
38 |
$334.89 |
| 90674 |
|
14 |
14 |
$301.15 |
| 97802 |
|
32 |
32 |
$142.51 |
| 90686 |
|
278 |
278 |
$119.19 |
| G0442 |
Annual alcohol misuse screening, 5 to 15 minutes |
41 |
41 |
$64.08 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
13 |
13 |
$23.13 |
| 99080 |
|
292 |
288 |
$0.00 |