| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,287 |
2,169 |
$206K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
451 |
439 |
$52K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
278 |
278 |
$32K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
268 |
268 |
$31K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,367 |
1,359 |
$29K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
227 |
217 |
$24K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
157 |
157 |
$20K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
145 |
145 |
$19K |
| U0003 |
Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r |
21 |
21 |
$2K |
| 96127 |
|
207 |
207 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
30 |
30 |
$993.00 |
| U0005 |
Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc, making use of high throughput technologies, completed within 2 calendar days from date of specimen collection (list separately in addition to either hcpcs code u0003 or u0004) as described by cms-2020-01-r2 |
20 |
20 |
$500.00 |
| 92551 |
|
384 |
384 |
$252.29 |
| 90686 |
|
353 |
353 |
$177.88 |
| 85018 |
|
12 |
12 |
$24.22 |
| 96160 |
|
84 |
84 |
$6.09 |
| 99173 |
|
50 |
50 |
$3.17 |
| 90670 |
|
37 |
37 |
$0.00 |