| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,104 |
2,914 |
$238K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,374 |
2,608 |
$166K |
| 99199 |
Unlisted special service, procedure or report |
26,136 |
17,780 |
$78K |
| 87428 |
|
319 |
242 |
$17K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
412 |
320 |
$13K |
| 87430 |
|
972 |
759 |
$11K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
530 |
371 |
$6K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
320 |
240 |
$4K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
684 |
503 |
$4K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
738 |
538 |
$4K |
| 80076 |
|
512 |
380 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
16 |
12 |
$1K |
| 80061 |
Lipid panel |
106 |
80 |
$858.21 |
| 36415 |
Collection of venous blood by venipuncture |
607 |
420 |
$802.73 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
29 |
24 |
$648.10 |
| 84443 |
Thyroid stimulating hormone (TSH) |
39 |
27 |
$389.04 |
| 90686 |
|
21 |
19 |
$18.81 |
| 3074F |
|
1,845 |
1,249 |
$0.26 |
| 3078F |
|
1,545 |
1,077 |
$0.22 |
| 3008F |
|
2,364 |
1,523 |
$0.12 |
| 3079F |
|
427 |
254 |
$0.05 |
| 99000 |
|
17 |
15 |
$0.00 |