| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,047 |
941 |
$127K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
569 |
517 |
$48K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
743 |
720 |
$24K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
95 |
94 |
$14K |
| 92552 |
|
225 |
225 |
$5K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
38 |
38 |
$5K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
47 |
44 |
$4K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
142 |
137 |
$3K |
| 90461 |
|
89 |
88 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
42 |
38 |
$683.27 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
37 |
37 |
$255.83 |
| 90686 |
|
77 |
76 |
$0.00 |
| 99177 |
|
568 |
466 |
$0.00 |
| 90670 |
|
12 |
12 |
$0.00 |