| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,486 |
3,265 |
$344K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,610 |
3,425 |
$242K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,815 |
1,764 |
$74K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
206 |
206 |
$21K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
150 |
146 |
$19K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
807 |
796 |
$17K |
| 99177 |
|
578 |
569 |
$11K |
| 99070 |
|
819 |
780 |
$10K |
| 96160 |
|
2,632 |
1,728 |
$10K |
| 92558 |
|
395 |
386 |
$9K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
145 |
110 |
$5K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
145 |
141 |
$4K |
| 96127 |
|
280 |
249 |
$4K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
13 |
13 |
$4K |
| 99215 |
Prolong outpt/office vis |
29 |
27 |
$4K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
40 |
40 |
$4K |
| 99050 |
|
288 |
283 |
$4K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
27 |
24 |
$2K |
| 87428 |
|
71 |
70 |
$2K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
40 |
38 |
$744.56 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
56 |
52 |
$525.81 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
30 |
15 |
$309.30 |
| 90480 |
|
14 |
13 |
$273.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
12 |
12 |
$198.00 |
| 94760 |
|
107 |
101 |
$170.98 |
| 90686 |
|
1,562 |
1,539 |
$20.53 |
| 99000 |
|
30 |
29 |
$0.00 |
| 85018 |
|
12 |
12 |
$0.00 |
| 99072 |
|
3,360 |
3,122 |
$0.00 |
| 99001 |
|
732 |
707 |
$0.00 |
| D0145 |
Oral evaluation for a patient under three years of age |
135 |
135 |
$0.00 |
| 91321 |
|
14 |
13 |
$0.00 |