| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,964 |
4,347 |
$264K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
8,181 |
6,231 |
$194K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,061 |
773 |
$43K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
839 |
537 |
$29K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
524 |
355 |
$19K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
431 |
318 |
$18K |
| 90686 |
|
1,214 |
673 |
$8K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
410 |
335 |
$7K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
123 |
95 |
$4K |
| 90698 |
|
391 |
273 |
$3K |
| 90670 |
|
392 |
271 |
$3K |
| 90688 |
|
250 |
219 |
$2K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
63 |
41 |
$2K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
27 |
19 |
$2K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
128 |
107 |
$1K |
| 92551 |
|
130 |
114 |
$968.59 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
38 |
27 |
$595.00 |
| 99173 |
|
29 |
28 |
$511.93 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
48 |
45 |
$489.06 |
| 90674 |
|
31 |
29 |
$443.11 |
| 90734 |
|
45 |
24 |
$416.68 |
| 90633 |
|
101 |
46 |
$353.72 |
| 96127 |
|
180 |
143 |
$304.27 |
| 90680 |
|
40 |
27 |
$291.52 |
| 90661 |
|
18 |
16 |
$247.20 |
| 90744 |
|
24 |
14 |
$124.29 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
205 |
186 |
$70.40 |
| 99072 |
|
730 |
654 |
$0.00 |
| 90687 |
|
16 |
15 |
$0.00 |
| G0315 |
Immunization counseling by a physician or other qualified health care professional for covid-19, ages under 21, 5-15 mins time (this code is used for the medicaid early and periodic screening, diagnostic, and treatment benefit (epsdt) |
88 |
45 |
$0.00 |