| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,344 |
2,870 |
$270K |
| S0281 |
Medical home program, comprehensive care coordination and planning, maintenance of plan |
26,359 |
24,975 |
$137K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,138 |
1,896 |
$123K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,230 |
2,010 |
$94K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
3,990 |
3,575 |
$73K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
408 |
407 |
$35K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
308 |
298 |
$25K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
207 |
200 |
$18K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
460 |
362 |
$18K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
184 |
161 |
$14K |
| 81002 |
|
1,722 |
1,648 |
$4K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
169 |
162 |
$2K |
| 96127 |
|
561 |
506 |
$2K |
| 87428 |
|
34 |
31 |
$1K |
| 0002A |
|
49 |
49 |
$1K |
| 0001A |
|
57 |
55 |
$931.70 |
| 0071A |
|
142 |
26 |
$717.16 |
| 0072A |
|
95 |
19 |
$655.51 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
42 |
29 |
$382.20 |
| 36416 |
|
43 |
39 |
$143.52 |
| 96161 |
|
12 |
12 |
$57.50 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
89 |
88 |
$57.48 |
| 90688 |
|
255 |
255 |
$17.84 |
| 90686 |
|
202 |
166 |
$0.00 |
| S8301 |
Infection control supplies, not otherwise specified |
153 |
107 |
$0.00 |
| 90651 |
|
45 |
41 |
$0.00 |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
24 |
16 |
$0.00 |
| 90723 |
|
12 |
12 |
$0.00 |
| 90680 |
|
12 |
12 |
$0.00 |
| 99173 |
|
1,649 |
1,563 |
$0.00 |
| 90734 |
|
30 |
30 |
$0.00 |
| 90687 |
|
114 |
114 |
$0.00 |
| 90682 |
|
20 |
20 |
$0.00 |
| 90670 |
|
68 |
66 |
$0.00 |
| 90658 |
|
26 |
14 |
$0.00 |
| 90633 |
|
21 |
21 |
$0.00 |
| 90648 |
|
77 |
76 |
$0.00 |
| 99072 |
|
155 |
112 |
$0.00 |
| U0004 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc, making use of high throughput technologies as described by cms-2020-01-r |
33 |
32 |
$0.00 |