| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,526 |
2,325 |
$167K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,714 |
1,603 |
$91K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
856 |
832 |
$29K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,107 |
1,083 |
$16K |
| 36415 |
Collection of venous blood by venipuncture |
4,201 |
3,828 |
$14K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
44 |
38 |
$3K |
| 90686 |
|
429 |
422 |
$3K |
| 80053 |
Comprehensive metabolic panel |
160 |
156 |
$2K |
| 85027 |
|
199 |
184 |
$1K |
| 80061 |
Lipid panel |
83 |
82 |
$1K |
| U0003 |
Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r |
14 |
14 |
$1K |
| 99188 |
|
99 |
94 |
$1K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
24 |
24 |
$976.12 |
| 92551 |
|
127 |
126 |
$936.21 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
12 |
12 |
$916.19 |
| 99442 |
|
20 |
14 |
$668.78 |
| 90688 |
|
90 |
90 |
$539.44 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
55 |
54 |
$501.30 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
25 |
25 |
$499.72 |
| 84443 |
Thyroid stimulating hormone (TSH) |
29 |
29 |
$475.43 |
| 96127 |
|
106 |
104 |
$428.60 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
68 |
62 |
$388.54 |
| U0005 |
Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc, making use of high throughput technologies, completed within 2 calendar days from date of specimen collection (list separately in addition to either hcpcs code u0003 or u0004) as described by cms-2020-01-r2 |
14 |
14 |
$360.20 |
| 90480 |
|
12 |
12 |
$314.77 |
| 90656 |
|
49 |
49 |
$308.66 |
| 99173 |
|
141 |
140 |
$224.67 |
| X5622 |
|
123 |
123 |
$0.00 |