| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,145 |
4,718 |
$262K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,954 |
5,491 |
$213K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
526 |
513 |
$24K |
| 90686 |
|
635 |
622 |
$7K |
| 87428 |
|
49 |
49 |
$7K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
44 |
44 |
$4K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
325 |
317 |
$4K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
109 |
107 |
$3K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
40 |
37 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
38 |
36 |
$3K |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
133 |
130 |
$3K |
| 0071A |
|
33 |
33 |
$1K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
13 |
12 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
13 |
13 |
$1K |
| 0072A |
|
18 |
18 |
$720.00 |
| 0012A |
|
12 |
12 |
$480.00 |
| 0064A |
|
14 |
14 |
$440.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
26 |
25 |
$376.50 |
| 36415 |
Collection of venous blood by venipuncture |
39 |
37 |
$112.08 |
| 90656 |
|
29 |
26 |
$104.27 |
| 90461 |
|
75 |
74 |
$73.57 |
| 85018 |
|
25 |
24 |
$69.69 |
| 91300 |
|
13 |
12 |
$0.00 |
| 99072 |
|
56 |
55 |
$0.00 |
| 91301 |
|
55 |
54 |
$0.00 |
| 91307 |
|
53 |
50 |
$0.00 |