| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
675 |
613 |
$8K |
| 92552 |
|
336 |
335 |
$2K |
| 99384 |
|
14 |
14 |
$2K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
300 |
300 |
$2K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
12 |
12 |
$1K |
| 99000 |
|
637 |
612 |
$577.17 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
14 |
14 |
$379.08 |
| 90633 |
|
57 |
57 |
$333.00 |
| 90716 |
|
55 |
55 |
$333.00 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
15 |
15 |
$256.55 |
| 90707 |
|
41 |
41 |
$243.00 |
| 90649 |
|
42 |
42 |
$180.00 |
| 90713 |
|
32 |
32 |
$171.00 |
| 90715 |
|
30 |
30 |
$162.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
16 |
16 |
$139.97 |
| 81025 |
|
51 |
50 |
$128.80 |
| 90648 |
|
12 |
12 |
$81.00 |
| 90723 |
|
12 |
12 |
$81.00 |
| 3078F |
|
148 |
148 |
$75.00 |
| 3008F |
|
114 |
114 |
$75.00 |
| 3074F |
|
136 |
136 |
$75.00 |
| 90734 |
|
19 |
19 |
$72.00 |
| 90744 |
|
12 |
12 |
$72.00 |
| 81000 |
|
115 |
115 |
$5.68 |
| 3725F |
|
130 |
130 |
$0.00 |
| 85018 |
|
35 |
35 |
$0.00 |
| 92060 |
|
13 |
13 |
$0.00 |