| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,948 |
3,323 |
$308K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,546 |
1,886 |
$131K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,640 |
1,233 |
$121K |
| 99199 |
Unlisted special service, procedure or report |
18,504 |
12,119 |
$103K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
665 |
528 |
$21K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,039 |
409 |
$11K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
363 |
282 |
$4K |
| 99335 |
|
76 |
58 |
$3K |
| 99401 |
|
122 |
80 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
13 |
12 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
97 |
76 |
$2K |
| 99336 |
|
33 |
24 |
$1K |
| 0011A |
|
27 |
26 |
$1K |
| 0012A |
|
23 |
22 |
$1K |
| 0002A |
|
50 |
15 |
$924.69 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
17 |
12 |
$503.04 |
| 81002 |
|
180 |
140 |
$380.42 |
| 99324 |
|
16 |
16 |
$291.23 |
| 99334 |
|
21 |
15 |
$201.66 |
| 92552 |
|
45 |
30 |
$194.30 |
| 81025 |
|
19 |
13 |
$93.60 |
| 96127 |
|
40 |
25 |
$81.45 |
| 90686 |
|
23 |
12 |
$56.40 |
| 3074F |
|
1,759 |
1,202 |
$0.00 |
| 3079F |
|
454 |
277 |
$0.00 |
| 3075F |
|
134 |
70 |
$0.00 |
| 1036F |
|
3,026 |
1,929 |
$0.00 |
| 1034F |
|
284 |
181 |
$0.00 |
| 99172 |
|
178 |
133 |
$0.00 |
| 3080F |
|
23 |
12 |
$0.00 |
| 91301 |
|
30 |
30 |
$0.00 |
| 1159F |
|
1,395 |
863 |
$0.00 |
| 3078F |
|
1,666 |
1,141 |
$0.00 |
| 99072 |
|
366 |
314 |
$0.00 |
| 1160F |
|
1,387 |
858 |
$0.00 |
| 3077F |
|
50 |
25 |
$0.00 |
| 91300 |
|
28 |
13 |
$0.00 |