| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,258 |
979 |
$74K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
125 |
112 |
$7K |
| 87428 |
|
117 |
113 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
208 |
190 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
24 |
22 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
128 |
99 |
$1K |
| 36415 |
Collection of venous blood by venipuncture |
132 |
103 |
$876.07 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
12 |
12 |
$687.60 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
57 |
50 |
$682.10 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
86 |
65 |
$604.63 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
15 |
14 |
$529.23 |
| 87400 |
|
56 |
28 |
$292.56 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
32 |
26 |
$119.64 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
16 |
13 |
$34.96 |
| 84460 |
|
17 |
14 |
$24.91 |
| 84450 |
|
17 |
14 |
$24.34 |
| 3078F |
|
150 |
131 |
$0.00 |
| 1159F |
|
161 |
145 |
$0.00 |
| 90670 |
|
13 |
13 |
$0.00 |
| 1160F |
|
160 |
144 |
$0.00 |
| 90633 |
|
14 |
12 |
$0.00 |
| 3074F |
|
134 |
118 |
$0.00 |
| 1036F |
|
126 |
114 |
$0.00 |
| 3079F |
|
12 |
12 |
$0.00 |