| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,022 |
1,916 |
$197K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,710 |
2,521 |
$186K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
963 |
893 |
$71K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
857 |
849 |
$71K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
638 |
637 |
$50K |
| 92552 |
|
2,480 |
2,464 |
$50K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
442 |
441 |
$38K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
3,125 |
1,763 |
$38K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
256 |
240 |
$28K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,682 |
1,262 |
$16K |
| 99215 |
Prolong outpt/office vis |
121 |
118 |
$16K |
| 99383 |
|
120 |
117 |
$11K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
473 |
454 |
$6K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
137 |
134 |
$6K |
| 99384 |
|
33 |
33 |
$3K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
193 |
95 |
$3K |
| 87807 |
|
238 |
222 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
33 |
33 |
$2K |
| 92567 |
|
201 |
198 |
$2K |
| 96127 |
|
453 |
449 |
$1K |
| 99382 |
|
12 |
12 |
$1K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
45 |
44 |
$1K |
| 83655 |
|
101 |
99 |
$895.49 |
| 81002 |
|
362 |
349 |
$867.21 |
| 36415 |
Collection of venous blood by venipuncture |
40 |
40 |
$183.75 |
| 36416 |
|
12 |
12 |
$68.76 |
| 90658 |
|
13 |
13 |
$37.21 |
| 85018 |
|
19 |
19 |
$36.88 |
| 90686 |
|
359 |
358 |
$0.00 |
| 90651 |
|
83 |
82 |
$0.00 |
| 90716 |
|
54 |
54 |
$0.00 |
| 90619 |
|
42 |
42 |
$0.00 |
| 90680 |
|
26 |
26 |
$0.00 |
| 99000 |
|
13 |
13 |
$0.00 |
| 90657 |
|
16 |
16 |
$0.00 |
| 90715 |
|
53 |
53 |
$0.00 |
| 90710 |
|
180 |
180 |
$0.00 |
| 90633 |
|
154 |
154 |
$0.00 |
| 99173 |
|
1,224 |
1,216 |
$0.00 |
| 90670 |
|
384 |
383 |
$0.00 |
| 90707 |
|
69 |
69 |
$0.00 |
| 90461 |
|
174 |
55 |
$0.00 |
| 90672 |
|
20 |
20 |
$0.00 |