| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,228 |
5,589 |
$255K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,838 |
2,609 |
$186K |
| 36415 |
Collection of venous blood by venipuncture |
2,845 |
2,591 |
$7K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
354 |
341 |
$4K |
| S0281 |
Medical home program, comprehensive care coordination and planning, maintenance of plan |
347 |
327 |
$3K |
| 90686 |
|
153 |
149 |
$1K |
| 90688 |
|
151 |
147 |
$906.64 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
17 |
17 |
$736.64 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
13 |
13 |
$400.38 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
13 |
12 |
$187.00 |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
33 |
31 |
$41.20 |
| 92551 |
|
41 |
37 |
$17.88 |
| 99173 |
|
28 |
24 |
$3.10 |
| G0008 |
Administration of influenza virus vaccine |
27 |
27 |
$0.00 |
| X5622 |
|
56 |
56 |
$0.00 |