| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,711 |
1,541 |
$72K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
873 |
776 |
$55K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,217 |
1,094 |
$46K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
497 |
464 |
$33K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
377 |
357 |
$27K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,072 |
895 |
$18K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
63 |
63 |
$5K |
| U0003 |
Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r |
17 |
17 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
182 |
84 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
14 |
14 |
$1K |
| 96127 |
|
281 |
235 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
14 |
13 |
$1K |
| 90686 |
|
592 |
523 |
$995.03 |
| 3008F |
|
254 |
222 |
$760.00 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
23 |
19 |
$690.92 |
| 99173 |
|
136 |
127 |
$487.55 |
| 90670 |
|
296 |
286 |
$485.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
81 |
62 |
$483.80 |
| 36415 |
Collection of venous blood by venipuncture |
167 |
136 |
$343.64 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
63 |
46 |
$314.86 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
20 |
20 |
$198.19 |
| 81003 |
|
42 |
40 |
$86.22 |
| 90688 |
|
46 |
41 |
$32.68 |
| D1206 |
Topical application of fluoride varnish |
116 |
114 |
$0.00 |
| 90680 |
|
97 |
97 |
$0.00 |
| 90723 |
|
21 |
21 |
$0.00 |
| 90698 |
|
17 |
17 |
$0.00 |
| 90744 |
|
12 |
12 |
$0.00 |
| 0502F |
|
133 |
103 |
$0.00 |
| 90707 |
|
15 |
13 |
$0.00 |
| 90687 |
|
12 |
12 |
$0.00 |
| 90648 |
|
48 |
48 |
$0.00 |
| D0190 |
|
116 |
114 |
$0.00 |
| 90633 |
|
20 |
19 |
$0.00 |