| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,961 |
1,385 |
$43K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
420 |
321 |
$18K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
211 |
131 |
$17K |
| 95117 |
|
807 |
281 |
$10K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
131 |
109 |
$6K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
183 |
105 |
$5K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
459 |
337 |
$4K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
126 |
120 |
$3K |
| 86318 |
|
105 |
104 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
12 |
12 |
$903.68 |
| 92567 |
|
46 |
46 |
$580.50 |
| 85018 |
|
290 |
179 |
$466.14 |
| 87807 |
|
40 |
35 |
$416.32 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
125 |
82 |
$388.02 |
| 96127 |
|
251 |
103 |
$327.54 |
| 90685 |
|
44 |
22 |
$309.00 |
| 90677 |
|
14 |
12 |
$157.68 |
| 90686 |
|
18 |
14 |
$154.50 |
| 36415 |
Collection of venous blood by venipuncture |
198 |
150 |
$93.60 |
| 90661 |
|
26 |
26 |
$50.90 |
| 99173 |
|
81 |
40 |
$44.20 |
| 92587 |
|
449 |
258 |
$0.00 |
| 36416 |
|
131 |
77 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
14 |
13 |
$0.00 |