| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
4,526 |
1,750 |
$143K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
9,510 |
4,924 |
$137K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,914 |
2,648 |
$124K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,514 |
1,423 |
$105K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,664 |
929 |
$85K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
2,498 |
1,270 |
$79K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
66 |
50 |
$4K |
| 99383 |
|
64 |
55 |
$3K |
| 99382 |
|
56 |
50 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
3,878 |
2,105 |
$1K |
| 99443 |
|
304 |
101 |
$424.97 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
232 |
125 |
$293.97 |
| 90715 |
|
319 |
107 |
$60.02 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
336 |
118 |
$39.72 |
| 90734 |
|
296 |
147 |
$30.00 |
| 90461 |
|
539 |
262 |
$0.00 |
| 90670 |
|
603 |
341 |
$0.00 |
| 99173 |
|
667 |
183 |
$0.00 |
| 92568 |
|
588 |
161 |
$0.00 |
| 90710 |
|
303 |
137 |
$0.00 |
| 90648 |
|
213 |
60 |
$0.00 |
| 90633 |
|
305 |
168 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
100 |
27 |
$0.00 |
| 90700 |
|
44 |
40 |
$0.00 |
| 90686 |
|
35 |
29 |
$0.00 |
| 90688 |
|
75 |
40 |
$0.00 |
| 90651 |
|
272 |
106 |
$0.00 |
| 90696 |
|
115 |
35 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,041 |
269 |
$0.00 |
| 90723 |
|
138 |
31 |
$0.00 |
| 90698 |
|
64 |
31 |
$0.00 |
| 90744 |
|
13 |
12 |
$0.00 |