| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,285 |
4,804 |
$824K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
266 |
170 |
$35K |
| X5622 |
|
15 |
13 |
$4K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
137 |
106 |
$45.96 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
166 |
152 |
$21.18 |
| 99173 |
|
49 |
41 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
192 |
171 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
702 |
578 |
$0.00 |
| 90686 |
|
67 |
66 |
$0.00 |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
30 |
26 |
$0.00 |
| 92551 |
|
13 |
12 |
$0.00 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
28 |
12 |
$0.00 |