| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
245 |
235 |
$9K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
125 |
114 |
$6K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
224 |
223 |
$6K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
13 |
13 |
$1K |
| 90686 |
|
196 |
194 |
$685.40 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$560.12 |
| 0071A |
|
14 |
14 |
$560.00 |
| 0072A |
|
13 |
13 |
$520.00 |
| 0002A |
|
13 |
13 |
$440.00 |
| 0012A |
|
14 |
14 |
$406.90 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
13 |
12 |
$196.32 |
| 90656 |
|
34 |
34 |
$98.85 |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
14 |
14 |
$92.32 |
| 0011A |
|
14 |
14 |
$91.84 |