| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,155 |
1,637 |
$69K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
175 |
172 |
$1K |
| 99000 |
|
143 |
139 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
13 |
13 |
$1K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
27 |
27 |
$1K |
| 99051 |
|
65 |
49 |
$591.63 |
| S8301 |
Infection control supplies, not otherwise specified |
19 |
19 |
$584.68 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
67 |
27 |
$525.28 |
| 90461 |
|
15 |
13 |
$112.02 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
16 |
16 |
$99.46 |
| 36415 |
Collection of venous blood by venipuncture |
175 |
171 |
$0.00 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
28 |
28 |
$0.00 |
| G9716 |
Bmi is documented as being outside of normal parameters, follow-up plan is not completed for documented medical reason |
28 |
28 |
$0.00 |
| 3008F |
|
28 |
28 |
$0.00 |
| 90686 |
|
13 |
13 |
$0.00 |