| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,776 |
2,469 |
$162K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,139 |
2,581 |
$124K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
303 |
302 |
$25K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
277 |
173 |
$12K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
324 |
193 |
$8K |
| 92551 |
|
1,508 |
1,132 |
$7K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
414 |
306 |
$7K |
| 99384 |
|
62 |
62 |
$7K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
142 |
83 |
$5K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
142 |
136 |
$5K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
74 |
74 |
$4K |
| 99383 |
|
39 |
39 |
$4K |
| 99382 |
|
30 |
29 |
$3K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
59 |
30 |
$1K |
| 99173 |
|
1,217 |
855 |
$815.99 |
| 90649 |
|
50 |
31 |
$423.39 |
| 99401 |
|
138 |
80 |
$373.75 |
| 96160 |
|
204 |
202 |
$359.29 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
22 |
22 |
$111.72 |
| 36415 |
Collection of venous blood by venipuncture |
24 |
24 |
$62.10 |
| 3351F |
|
146 |
146 |
$0.00 |
| 3008F |
|
410 |
407 |
$0.00 |
| 90651 |
|
16 |
16 |
$0.00 |
| 90633 |
|
66 |
47 |
$0.00 |
| 90715 |
|
13 |
13 |
$0.00 |
| 90734 |
|
65 |
47 |
$0.00 |