| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
8,338 |
7,241 |
$797K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
7,736 |
7,233 |
$470K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,498 |
1,478 |
$143K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,474 |
1,380 |
$133K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
909 |
905 |
$93K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
3,712 |
3,664 |
$58K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
566 |
553 |
$52K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
231 |
226 |
$25K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,279 |
1,277 |
$9K |
| 90686 |
|
698 |
697 |
$1K |
| 96127 |
|
137 |
137 |
$723.69 |
| 0071A |
|
16 |
16 |
$665.20 |
| 0072A |
|
12 |
12 |
$496.80 |
| 90677 |
|
73 |
68 |
$275.26 |
| 90697 |
|
25 |
25 |
$154.14 |
| 90656 |
|
155 |
155 |
$0.67 |
| 90651 |
|
24 |
24 |
$0.06 |
| 90680 |
|
24 |
24 |
$0.00 |
| 90698 |
|
42 |
42 |
$0.00 |
| 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 |
65 |
65 |
$0.00 |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
169 |
168 |
$0.00 |
| 90670 |
|
121 |
121 |
$0.00 |