| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,462 |
3,163 |
$169K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
588 |
505 |
$49K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
376 |
299 |
$28K |
| 92015 |
Determination of refractive state |
1,249 |
1,128 |
$22K |
| 92587 |
|
1,274 |
1,019 |
$16K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
481 |
455 |
$12K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
74 |
42 |
$6K |
| 90686 |
|
436 |
388 |
$5K |
| 36415 |
Collection of venous blood by venipuncture |
1,006 |
845 |
$4K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
240 |
212 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
51 |
49 |
$4K |
| 88738 |
|
380 |
290 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
87 |
83 |
$1K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
25 |
25 |
$1K |
| 86580 |
|
216 |
159 |
$1K |
| 0001A |
|
24 |
21 |
$1K |
| 90658 |
|
132 |
120 |
$964.44 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
26 |
26 |
$883.26 |
| 90651 |
|
85 |
64 |
$863.61 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
12 |
12 |
$834.24 |
| 90734 |
|
57 |
47 |
$661.65 |
| 83655 |
|
54 |
35 |
$628.58 |
| 85018 |
|
242 |
223 |
$540.56 |
| 90620 |
|
22 |
16 |
$428.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
28 |
28 |
$414.74 |
| 90707 |
|
22 |
13 |
$140.80 |
| 90716 |
|
22 |
13 |
$140.80 |
| 90744 |
|
16 |
13 |
$102.40 |
| 91300 |
|
13 |
12 |
$25.04 |
| G0438 |
Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit |
21 |
14 |
$0.00 |