| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
1,779 |
1,491 |
$170K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,582 |
4,593 |
$167K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
3,133 |
1,474 |
$36K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
918 |
796 |
$31K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
348 |
343 |
$28K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
321 |
315 |
$27K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
766 |
631 |
$22K |
| 99384 |
|
300 |
280 |
$17K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,478 |
1,347 |
$16K |
| 99383 |
|
240 |
226 |
$13K |
| 99000 |
|
1,516 |
1,224 |
$12K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
115 |
110 |
$8K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
411 |
365 |
$8K |
| 92551 |
|
2,160 |
2,044 |
$7K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
192 |
153 |
$7K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
93 |
90 |
$7K |
| 99309 |
Subsequent nursing facility care, per day, low to moderate complexity |
975 |
925 |
$5K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
115 |
109 |
$5K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
621 |
585 |
$4K |
| 90461 |
|
917 |
714 |
$2K |
| S8301 |
Infection control supplies, not otherwise specified |
389 |
325 |
$2K |
| 99408 |
|
275 |
267 |
$2K |
| 97169 |
|
121 |
108 |
$1K |
| 93000 |
|
140 |
125 |
$1K |
| 99385 |
|
13 |
13 |
$1K |
| 99382 |
|
35 |
31 |
$818.05 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
28 |
28 |
$657.11 |
| 99308 |
Subsequent nursing facility care, per day, straightforward |
639 |
611 |
$484.63 |
| 99490 |
Ccm add 20min |
1,037 |
1,023 |
$479.42 |
| 99491 |
Ccm add 20min |
683 |
668 |
$211.73 |
| 90734 |
|
137 |
133 |
$162.47 |
| 99305 |
|
17 |
17 |
$146.19 |
| 81000 |
|
59 |
56 |
$108.16 |
| 81025 |
|
12 |
12 |
$83.08 |
| 99001 |
|
23 |
13 |
$29.82 |
| 90686 |
|
118 |
111 |
$17.54 |
| 99306 |
Prolong nursin fac eval 15m |
22 |
22 |
$2.80 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
420 |
370 |
$0.00 |
| 99173 |
|
2,064 |
1,939 |
$0.00 |
| 91300 |
|
15 |
14 |
$0.00 |
| 99497 |
|
126 |
109 |
$0.00 |
| 90670 |
|
106 |
103 |
$0.00 |
| 90633 |
|
112 |
106 |
$0.00 |
| 90710 |
|
63 |
61 |
$0.00 |
| 99397 |
|
48 |
48 |
$0.00 |
| 90700 |
|
49 |
42 |
$0.00 |
| 90713 |
|
32 |
30 |
$0.00 |
| 90715 |
|
107 |
100 |
$0.00 |
| 99310 |
Prolong nursin fac eval 15m |
38 |
25 |
$0.00 |
| 90648 |
|
24 |
24 |
$0.00 |
| 90707 |
|
29 |
26 |
$0.00 |
| G0438 |
Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit |
12 |
12 |
$0.00 |
| 90644 |
|
14 |
12 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
213 |
202 |
$0.00 |
| 96127 |
|
645 |
621 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
51 |
40 |
$0.00 |
| 96161 |
|
63 |
60 |
$0.00 |
| 90651 |
|
106 |
104 |
$0.00 |
| 90723 |
|
30 |
27 |
$0.00 |
| 90716 |
|
26 |
24 |
$0.00 |
| G0506 |
Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service) |
21 |
17 |
$0.00 |