| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,720 |
4,044 |
$155K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,661 |
1,531 |
$88K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
157 |
146 |
$52K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
991 |
905 |
$32K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,339 |
698 |
$20K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
251 |
243 |
$15K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,135 |
1,012 |
$15K |
| V2020 |
Frames, purchases |
187 |
185 |
$4K |
| G0467 |
Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit |
288 |
110 |
$3K |
| 99173 |
|
104 |
98 |
$3K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
55 |
52 |
$3K |
| T1015 |
Clinic visit/encounter, all-inclusive |
437 |
422 |
$2K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
324 |
323 |
$2K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
426 |
388 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
357 |
344 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
31 |
30 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
18 |
18 |
$2K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
27 |
27 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
77 |
68 |
$1K |
| 92015 |
Determination of refractive state |
390 |
378 |
$1K |
| 36415 |
Collection of venous blood by venipuncture |
1,112 |
1,010 |
$1K |
| 90674 |
|
56 |
49 |
$1K |
| 80305 |
|
132 |
124 |
$997.52 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12 |
12 |
$942.96 |
| 90461 |
|
78 |
76 |
$811.60 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
31 |
31 |
$800.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
64 |
63 |
$608.00 |
| 99460 |
|
13 |
13 |
$597.87 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
16 |
15 |
$460.81 |
| 90661 |
|
14 |
14 |
$403.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
27 |
24 |
$402.30 |
| 92558 |
|
28 |
27 |
$186.51 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
14 |
14 |
$186.48 |
| 92551 |
|
15 |
14 |
$139.60 |
| 87420 |
|
12 |
12 |
$139.10 |
| 99177 |
|
29 |
26 |
$59.15 |
| 3044F |
|
57 |
57 |
$0.28 |
| 3078F |
|
58 |
58 |
$0.25 |
| 3074F |
|
58 |
58 |
$0.25 |
| 3075F |
|
38 |
38 |
$0.23 |
| 3079F |
|
15 |
15 |
$0.08 |
| 1036F |
|
100 |
93 |
$0.06 |
| 90686 |
|
27 |
27 |
$0.01 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
260 |
246 |
$0.00 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
28 |
27 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
531 |
488 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
13 |
13 |
$0.00 |