| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,675 |
5,195 |
$295K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,799 |
3,488 |
$250K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
808 |
707 |
$55K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
3,373 |
3,226 |
$45K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
436 |
422 |
$32K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,313 |
1,247 |
$18K |
| 36415 |
Collection of venous blood by venipuncture |
1,084 |
1,028 |
$4K |
| 99215 |
Prolong outpt/office vis |
28 |
25 |
$4K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
51 |
50 |
$3K |
| 0002A |
|
71 |
70 |
$3K |
| 90686 |
|
696 |
670 |
$2K |
| 0001A |
|
47 |
47 |
$2K |
| T1013 |
Sign language or oral interpretive services, per 15 minutes |
157 |
132 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
14 |
13 |
$1K |
| 0071A |
|
17 |
16 |
$674.95 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
42 |
20 |
$639.12 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
12 |
12 |
$637.93 |
| 90480 |
|
21 |
19 |
$558.30 |
| 0003A |
|
12 |
12 |
$537.60 |
| 90670 |
|
162 |
154 |
$451.30 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
54 |
54 |
$448.27 |
| 36416 |
|
44 |
39 |
$131.78 |
| 96127 |
|
23 |
12 |
$83.89 |
| 90656 |
|
32 |
31 |
$44.78 |
| 1159F |
|
7,354 |
6,776 |
$0.00 |
| 3078F |
|
877 |
835 |
$0.00 |
| 3725F |
|
216 |
202 |
$0.00 |
| X5622 |
|
53 |
53 |
$0.00 |
| 4013F |
|
13 |
12 |
$0.00 |
| 1000F |
|
7,934 |
7,227 |
$0.00 |
| 1170F |
|
8,222 |
7,283 |
$0.00 |
| 3008F |
|
1,753 |
1,600 |
$0.00 |
| 3074F |
|
797 |
755 |
$0.00 |
| 3075F |
|
26 |
24 |
$0.00 |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
59 |
54 |
$0.00 |
| 90698 |
|
97 |
94 |
$0.00 |