| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,085 |
2,499 |
$166K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
727 |
495 |
$52K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
547 |
358 |
$39K |
| 86328 |
|
134 |
133 |
$4K |
| 99442 |
|
41 |
26 |
$3K |
| 99441 |
|
38 |
28 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
289 |
278 |
$1K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
15 |
15 |
$982.45 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
151 |
149 |
$843.58 |
| 3074F |
|
867 |
823 |
$813.34 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
65 |
65 |
$726.50 |
| 90686 |
|
75 |
75 |
$718.05 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
121 |
120 |
$667.22 |
| 3078F |
|
616 |
587 |
$564.80 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
121 |
121 |
$423.74 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
20 |
16 |
$317.00 |
| 3079F |
|
211 |
202 |
$255.00 |
| 3077F |
|
176 |
169 |
$255.00 |
| 3080F |
|
153 |
147 |
$235.00 |
| 87807 |
|
12 |
12 |
$117.90 |
| 81002 |
|
47 |
47 |
$76.33 |
| 81025 |
|
27 |
27 |
$49.05 |
| S9088 |
Services provided in an urgent care center (list in addition to code for service) |
169 |
168 |
$45.01 |
| 36416 |
|
211 |
203 |
$42.40 |
| 82962 |
|
25 |
25 |
$19.01 |
| 92551 |
|
13 |
13 |
$17.28 |
| 1160F |
|
728 |
709 |
$15.00 |
| 1159F |
|
740 |
721 |
$15.00 |
| 3075F |
|
16 |
16 |
$10.00 |
| 3008F |
|
2,592 |
2,404 |
$0.00 |
| 1036F |
|
2,133 |
1,965 |
$0.00 |
| 3725F |
|
2,518 |
2,326 |
$0.00 |
| 4004F |
|
13 |
12 |
$0.00 |
| S9083 |
Global fee urgent care centers |
66 |
65 |
$0.00 |