| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,412 |
4,569 |
$306K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,291 |
1,684 |
$133K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
800 |
557 |
$26K |
| 99199 |
Unlisted special service, procedure or report |
4,231 |
3,916 |
$15K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,139 |
421 |
$13K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
379 |
213 |
$5K |
| 87428 |
|
86 |
51 |
$4K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
254 |
207 |
$4K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
283 |
214 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
31 |
26 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
23 |
19 |
$2K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
12 |
12 |
$449.90 |
| 90688 |
|
49 |
49 |
$410.16 |
| 92552 |
|
64 |
53 |
$275.56 |
| 90756 |
|
21 |
13 |
$210.45 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
27 |
27 |
$183.53 |
| 81002 |
|
12 |
12 |
$39.72 |
| 99173 |
|
154 |
132 |
$18.32 |
| 92551 |
|
24 |
22 |
$3.02 |
| 3008F |
|
1,371 |
958 |
$0.41 |
| G8752 |
Most recent systolic blood pressure < 140 mmhg |
1,323 |
1,161 |
$0.00 |
| 3078F |
|
1,204 |
814 |
$0.00 |
| G8754 |
Most recent diastolic blood pressure < 90 mmhg |
1,330 |
1,168 |
$0.00 |
| 3074F |
|
1,236 |
838 |
$0.00 |