| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,540 |
2,464 |
$197K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,849 |
1,810 |
$94K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
641 |
640 |
$60K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
485 |
484 |
$44K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
386 |
383 |
$35K |
| 99051 |
|
879 |
875 |
$25K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
199 |
199 |
$19K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
442 |
434 |
$6K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
121 |
119 |
$5K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
280 |
138 |
$3K |
| 99215 |
Prolong outpt/office vis |
27 |
27 |
$3K |
| 87428 |
|
72 |
71 |
$2K |
| 99173 |
|
682 |
682 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
19 |
19 |
$657.80 |
| 90686 |
|
308 |
307 |
$542.00 |
| 99188 |
|
26 |
26 |
$519.00 |
| 92551 |
|
832 |
832 |
$439.10 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
540 |
540 |
$363.29 |
| 99177 |
|
229 |
229 |
$332.73 |
| 96127 |
|
389 |
389 |
$249.92 |
| 96160 |
|
390 |
390 |
$217.47 |
| 80061 |
Lipid panel |
15 |
15 |
$121.05 |
| 85018 |
|
32 |
32 |
$8.14 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
158 |
158 |
$0.00 |
| 96161 |
|
197 |
197 |
$0.00 |
| 90723 |
|
56 |
56 |
$0.00 |
| 90680 |
|
29 |
29 |
$0.00 |
| 90656 |
|
60 |
60 |
$0.00 |
| 90677 |
|
32 |
32 |
$0.00 |
| 90651 |
|
31 |
31 |
$0.00 |
| 90619 |
|
14 |
14 |
$0.00 |
| 90648 |
|
157 |
157 |
$0.00 |
| 90661 |
|
64 |
64 |
$0.00 |
| G9920 |
Screening performed and negative |
427 |
427 |
$0.00 |
| 83655 |
|
17 |
17 |
$0.00 |
| 90670 |
|
122 |
122 |
$0.00 |
| 90633 |
|
13 |
13 |
$0.00 |