| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,939 |
1,740 |
$173K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,216 |
1,128 |
$146K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
516 |
516 |
$59K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
458 |
458 |
$53K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,728 |
1,708 |
$38K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
275 |
270 |
$36K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
167 |
167 |
$21K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
187 |
177 |
$19K |
| 96127 |
|
374 |
374 |
$2K |
| 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 |
24 |
24 |
$2K |
| 87634 |
|
16 |
16 |
$1K |
| 92551 |
|
743 |
743 |
$706.72 |
| 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 |
24 |
24 |
$550.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
27 |
27 |
$342.56 |
| 90686 |
|
552 |
552 |
$91.62 |
| 85018 |
|
12 |
12 |
$28.44 |
| 36415 |
Collection of venous blood by venipuncture |
12 |
12 |
$15.00 |
| 96160 |
|
123 |
122 |
$9.22 |
| 90670 |
|
15 |
15 |
$0.00 |
| 99173 |
|
49 |
49 |
$0.00 |
| 90707 |
|
26 |
26 |
$0.00 |
| 90734 |
|
12 |
12 |
$0.00 |
| 36416 |
|
12 |
12 |
$0.00 |
| 90744 |
|
12 |
12 |
$0.00 |