| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
448 |
405 |
$29K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
134 |
134 |
$15K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
365 |
362 |
$12K |
| 97802 |
|
305 |
305 |
$11K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
89 |
89 |
$10K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
90 |
90 |
$10K |
| 92587 |
|
310 |
310 |
$7K |
| 0001A |
|
85 |
85 |
$4K |
| 0072A |
|
77 |
77 |
$3K |
| 0081A |
|
73 |
73 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
34 |
29 |
$3K |
| 0071A |
|
65 |
65 |
$3K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
80 |
79 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
16 |
16 |
$2K |
| 0082A |
|
51 |
51 |
$2K |
| 99401 |
|
65 |
65 |
$2K |
| H0049 |
Alcohol and/or drug screening |
80 |
80 |
$2K |
| 0003A |
|
43 |
43 |
$2K |
| 90461 |
|
16 |
16 |
$921.06 |
| 0002A |
|
22 |
22 |
$915.72 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
51 |
27 |
$473.50 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
37 |
33 |
$379.71 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
17 |
16 |
$303.28 |
| 90677 |
|
39 |
39 |
$289.04 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
24 |
24 |
$269.04 |
| 90686 |
|
196 |
195 |
$39.37 |
| 36415 |
Collection of venous blood by venipuncture |
326 |
325 |
$29.60 |
| 99051 |
|
63 |
63 |
$28.00 |
| 99173 |
|
246 |
246 |
$19.30 |
| 91308 |
|
128 |
120 |
$1.27 |
| 91307 |
|
113 |
105 |
$0.93 |
| 91300 |
|
75 |
63 |
$0.31 |
| 91305 |
|
15 |
15 |
$0.05 |
| 1000F |
|
80 |
80 |
$0.00 |
| 96127 |
|
55 |
55 |
$0.00 |
| G9275 |
Documentation that patient is a current non-tobacco user |
28 |
28 |
$0.00 |
| 1220F |
|
80 |
80 |
$0.00 |
| 99174 |
|
50 |
50 |
$0.00 |
| 99000 |
|
440 |
431 |
$0.00 |
| 90744 |
|
13 |
13 |
$0.00 |
| 1036F |
|
28 |
28 |
$0.00 |
| 90651 |
|
25 |
25 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
80 |
80 |
$0.00 |
| 4293F |
|
80 |
80 |
$0.00 |
| 99408 |
|
86 |
86 |
$0.00 |
| 3725F |
|
55 |
55 |
$0.00 |