| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,086 |
1,899 |
$113K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
371 |
353 |
$30K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
30 |
28 |
$1K |
| 36415 |
Collection of venous blood by venipuncture |
369 |
327 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
13 |
13 |
$938.04 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
13 |
13 |
$678.99 |
| 92551 |
|
62 |
62 |
$527.09 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
12 |
12 |
$292.98 |
| 99173 |
|
68 |
68 |
$134.93 |
| 81003 |
|
13 |
12 |
$22.50 |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
301 |
296 |
$0.00 |
| X5622 |
|
82 |
82 |
$0.00 |