| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
334 |
303 |
$34K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
288 |
269 |
$20K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
82 |
82 |
$9K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
60 |
60 |
$6K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
34 |
34 |
$3K |
| 90461 |
|
92 |
92 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
154 |
154 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
124 |
116 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
13 |
13 |
$559.13 |
| 81003 |
|
202 |
199 |
$388.00 |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
15 |
15 |
$351.90 |
| 80061 |
Lipid panel |
24 |
24 |
$278.64 |
| 99051 |
|
24 |
24 |
$252.00 |
| 85018 |
|
123 |
123 |
$250.10 |
| 83655 |
|
17 |
17 |
$178.33 |
| 85014 |
|
55 |
55 |
$112.75 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
14 |
14 |
$87.49 |
| 36415 |
Collection of venous blood by venipuncture |
12 |
12 |
$25.56 |
| 90686 |
|
20 |
20 |
$0.00 |
| 90651 |
|
32 |
32 |
$0.00 |
| 90734 |
|
26 |
26 |
$0.00 |
| 90670 |
|
14 |
14 |
$0.00 |
| 90715 |
|
24 |
24 |
$0.00 |