| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
9,538 |
7,096 |
$716K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,557 |
2,691 |
$266K |
| X5622 |
|
147 |
131 |
$12K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
97 |
87 |
$3K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
63 |
63 |
$3K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
68 |
61 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
26 |
26 |
$3K |
| 36415 |
Collection of venous blood by venipuncture |
900 |
654 |
$2K |
| 80053 |
Comprehensive metabolic panel |
29 |
15 |
$824.65 |
| 84443 |
Thyroid stimulating hormone (TSH) |
21 |
13 |
$376.34 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,623 |
1,378 |
$370.79 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
23 |
12 |
$255.42 |
| 99188 |
|
83 |
80 |
$241.02 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
181 |
144 |
$202.59 |
| 85027 |
|
220 |
196 |
$195.98 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
546 |
530 |
$181.95 |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
75 |
29 |
$149.55 |
| 0240U |
|
12 |
12 |
$146.91 |
| 90686 |
|
1,540 |
1,302 |
$105.41 |
| 90480 |
|
22 |
12 |
$91.40 |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
219 |
115 |
$35.09 |
| T1013 |
Sign language or oral interpretive services, per 15 minutes |
40 |
26 |
$18.95 |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
213 |
188 |
$0.00 |
| 92551 |
|
124 |
118 |
$0.00 |
| 0001A |
|
170 |
166 |
$0.00 |
| 0031A |
|
28 |
28 |
$0.00 |
| 91303 |
|
28 |
28 |
$0.00 |
| 90656 |
|
21 |
14 |
$0.00 |
| 91305 |
|
16 |
14 |
$0.00 |
| 91300 |
|
472 |
396 |
$0.00 |
| 99173 |
|
123 |
113 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
391 |
343 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
120 |
103 |
$0.00 |
| 0004A |
|
32 |
32 |
$0.00 |
| 0002A |
|
147 |
147 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
36 |
30 |
$0.00 |