| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
649 |
531 |
$139.86 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,162 |
1,096 |
$92.72 |
| 80061 |
Lipid panel |
1,531 |
1,528 |
$0.00 |
| 90461 |
|
277 |
276 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
884 |
720 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,230 |
935 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,034 |
1,028 |
$0.00 |
| 99442 |
|
243 |
236 |
$0.00 |
| 99173 |
|
897 |
894 |
$0.00 |
| 80076 |
|
26 |
26 |
$0.00 |
| 90734 |
|
80 |
80 |
$0.00 |
| U0003 |
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, making use of high throughput technologies as described by cms-2020-01-r |
29 |
29 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
823 |
695 |
$0.00 |
| 90670 |
|
26 |
26 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
132 |
120 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
91 |
91 |
$0.00 |
| 84450 |
|
40 |
40 |
$0.00 |
| 90649 |
|
109 |
109 |
$0.00 |
| 85014 |
|
146 |
146 |
$0.00 |
| 99201 |
|
12 |
12 |
$0.00 |
| 86703 |
|
80 |
80 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
87 |
87 |
$0.00 |
| 92565 |
|
93 |
93 |
$0.00 |
| G9920 |
Screening performed and negative |
29 |
29 |
$0.00 |
| 83655 |
|
12 |
12 |
$0.00 |
| 82947 |
|
40 |
40 |
$0.00 |
| D0220 |
Intraoral - periapical first radiographic image |
15 |
12 |
$0.00 |
| 99441 |
|
832 |
780 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,924 |
3,053 |
$0.00 |
| 85018 |
|
146 |
146 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
563 |
563 |
$0.00 |
| 92551 |
|
616 |
614 |
$0.00 |
| 1220F |
|
108 |
105 |
$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 |
43 |
43 |
$0.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
1,336 |
1,331 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
3,328 |
3,257 |
$0.00 |
| 90686 |
|
268 |
268 |
$0.00 |
| 85027 |
|
1,015 |
1,013 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
586 |
585 |
$0.00 |
| 4450F |
|
697 |
683 |
$0.00 |
| 2001F |
|
31 |
30 |
$0.00 |
| 90656 |
|
67 |
67 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
32 |
31 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
26 |
26 |
$0.00 |
| 80053 |
Comprehensive metabolic panel |
120 |
120 |
$0.00 |
| 90651 |
|
51 |
51 |
$0.00 |
| 86780 |
|
40 |
40 |
$0.00 |
| 70300 |
|
12 |
12 |
$0.00 |
| 85008 |
|
70 |
70 |
$0.00 |
| 81001 |
|
33 |
33 |
$0.00 |
| 82728 |
|
16 |
16 |
$0.00 |
| 99443 |
|
26 |
26 |
$0.00 |
| D0140 |
Limited oral evaluation - problem focused |
15 |
13 |
$0.00 |
| 81015 |
|
21 |
21 |
$0.00 |