| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,631 |
4,806 |
$298K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
1,333 |
914 |
$178K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
724 |
675 |
$94K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,338 |
2,099 |
$80K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,362 |
1,280 |
$69K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
952 |
718 |
$52K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
271 |
175 |
$46K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
606 |
535 |
$44K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
2,797 |
2,559 |
$37K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
140 |
133 |
$10K |
| 99282 |
Emergency department visit for the evaluation and management, low to moderate severity |
115 |
73 |
$8K |
| A0425 |
Ground mileage, per statute mile |
304 |
136 |
$8K |
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
56 |
27 |
$3K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
34 |
29 |
$3K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
147 |
122 |
$3K |
| 99490 |
Ccm add 20min |
221 |
221 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
28 |
28 |
$2K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
19 |
12 |
$1K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
12 |
12 |
$493.90 |
| 87400 |
|
12 |
12 |
$361.92 |
| 36415 |
Collection of venous blood by venipuncture |
237 |
185 |
$345.60 |
| 80053 |
Comprehensive metabolic panel |
64 |
63 |
$246.24 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
12 |
12 |
$227.47 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
39 |
39 |
$201.60 |
| 85027 |
|
69 |
55 |
$112.36 |
| 90670 |
|
131 |
117 |
$0.35 |
| 90648 |
|
79 |
65 |
$0.33 |
| 90723 |
|
37 |
25 |
$0.12 |
| 90671 |
|
26 |
25 |
$0.01 |
| 90461 |
|
87 |
87 |
$0.00 |
| 90633 |
|
28 |
28 |
$0.00 |
| 90647 |
|
53 |
51 |
$0.00 |