| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
214 |
193 |
$26K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
819 |
812 |
$25K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
336 |
336 |
$22K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
115 |
106 |
$10K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
146 |
146 |
$8K |
| 90461 |
|
239 |
238 |
$8K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
111 |
111 |
$7K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
602 |
600 |
$7K |
| 92587 |
|
289 |
289 |
$6K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
146 |
134 |
$4K |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
381 |
381 |
$4K |
| 90677 |
|
12 |
12 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
30 |
30 |
$3K |
| 86580 |
|
219 |
219 |
$2K |
| 81000 |
|
395 |
391 |
$1K |
| 93000 |
|
77 |
77 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
60 |
35 |
$1K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
158 |
158 |
$951.16 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
209 |
208 |
$515.00 |
| G0270 |
Medical nutrition therapy; reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition or treatment regimen (including additional hours needed for renal disease), individual, face to face with the patient, each 15 minutes |
147 |
147 |
$384.25 |
| 92568 |
|
31 |
31 |
$361.07 |
| 92567 |
|
32 |
32 |
$347.82 |
| 82947 |
|
92 |
92 |
$286.64 |
| H0001 |
Alcohol and/or drug assessment |
26 |
25 |
$260.00 |
| 90674 |
|
36 |
36 |
$70.00 |
| 96160 |
|
67 |
66 |
$24.57 |
| 90686 |
|
31 |
31 |
$20.53 |
| 91307 |
|
17 |
15 |
$0.17 |
| 90670 |
|
54 |
54 |
$0.00 |
| 92550 |
|
29 |
29 |
$0.00 |
| 99000 |
|
45 |
45 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
146 |
146 |
$0.00 |
| 90680 |
|
14 |
14 |
$0.00 |
| 90744 |
|
12 |
12 |
$0.00 |
| 90698 |
|
13 |
13 |
$0.00 |