| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
15,255 |
13,998 |
$773K |
| S0281 |
Medical home program, comprehensive care coordination and planning, maintenance of plan |
131,388 |
127,113 |
$742K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,900 |
2,631 |
$137K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,122 |
1,914 |
$134K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,274 |
1,198 |
$95K |
| 90837 |
Psychotherapy, 53 minutes with patient |
695 |
374 |
$35K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
447 |
377 |
$33K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
238 |
198 |
$10K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
101 |
98 |
$9K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
1,612 |
1,334 |
$8K |
| 99215 |
Prolong outpt/office vis |
84 |
73 |
$8K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
86 |
85 |
$7K |
| 36415 |
Collection of venous blood by venipuncture |
3,679 |
2,971 |
$5K |
| 87428 |
|
85 |
84 |
$4K |
| 99490 |
Ccm add 20min |
573 |
549 |
$4K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
25 |
25 |
$3K |
| 80053 |
Comprehensive metabolic panel |
499 |
400 |
$3K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
103 |
85 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
56 |
55 |
$2K |
| S0280 |
Medical home program, comprehensive care coordination and planning, initial plan |
405 |
405 |
$1K |
| 0001A |
|
128 |
128 |
$892.25 |
| 0002A |
|
101 |
101 |
$885.18 |
| 90670 |
|
396 |
365 |
$882.65 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
59 |
56 |
$761.46 |
| 97803 |
|
15 |
14 |
$711.64 |
| 0071A |
|
27 |
17 |
$680.00 |
| 90680 |
|
100 |
98 |
$396.25 |
| 90723 |
|
99 |
99 |
$354.55 |
| 96127 |
|
59 |
57 |
$294.32 |
| 99000 |
|
46 |
45 |
$291.28 |
| 87301 |
|
19 |
19 |
$256.36 |
| 84443 |
Thyroid stimulating hormone (TSH) |
15 |
12 |
$181.08 |
| 87807 |
|
17 |
12 |
$158.76 |
| 90647 |
|
80 |
76 |
$101.95 |
| 80061 |
Lipid panel |
19 |
14 |
$95.55 |
| 81001 |
|
30 |
27 |
$77.04 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
18 |
14 |
$55.86 |
| 90686 |
|
170 |
158 |
$37.10 |
| 90656 |
|
12 |
12 |
$17.28 |
| 90461 |
|
1,132 |
976 |
$0.00 |