| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,120 |
3,455 |
$374K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,847 |
1,820 |
$24K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
140 |
140 |
$16K |
| 92552 |
|
543 |
543 |
$11K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
85 |
85 |
$10K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
626 |
345 |
$9K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
215 |
202 |
$8K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
50 |
47 |
$7K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,255 |
1,156 |
$6K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
25 |
25 |
$3K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
26 |
24 |
$3K |
| 87070 |
|
293 |
270 |
$2K |
| 81000 |
|
587 |
585 |
$2K |
| 85013 |
|
805 |
805 |
$2K |
| 81002 |
|
150 |
150 |
$299.11 |
| 99000 |
|
1,268 |
1,165 |
$122.98 |
| 90686 |
|
330 |
329 |
$101.73 |
| 99173 |
|
140 |
140 |
$101.09 |
| 36416 |
|
628 |
626 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
33 |
32 |
$0.00 |
| 90461 |
|
124 |
124 |
$0.00 |