| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 98960 |
|
2,201 |
2,088 |
$47K |
| T1017 |
Targeted case management, each 15 minutes |
122 |
79 |
$37K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,225 |
3,734 |
$27K |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
39 |
37 |
$22K |
| A0425 |
Ground mileage, per statute mile |
421 |
381 |
$13K |
| 90686 |
|
732 |
702 |
$13K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
909 |
850 |
$7K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
110 |
106 |
$5K |
| 0012A |
|
147 |
121 |
$3K |
| 0001A |
|
81 |
76 |
$3K |
| 99441 |
|
189 |
186 |
$3K |
| 0002A |
|
56 |
54 |
$2K |
| 0031A |
|
49 |
49 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
115 |
103 |
$2K |
| 90651 |
|
89 |
85 |
$2K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
44 |
42 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
283 |
262 |
$2K |
| 98961 |
|
121 |
121 |
$1K |
| 98962 |
|
132 |
130 |
$992.50 |
| 90734 |
|
30 |
26 |
$583.81 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
19 |
19 |
$532.76 |
| 96160 |
|
874 |
817 |
$520.14 |
| 0064A |
|
15 |
13 |
$480.00 |
| 90633 |
|
14 |
14 |
$307.44 |
| 99442 |
|
13 |
12 |
$304.88 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
62 |
37 |
$231.80 |
| 90688 |
|
14 |
13 |
$168.80 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
12 |
12 |
$141.41 |
| 0011A |
|
60 |
35 |
$136.94 |
| 96127 |
|
30 |
30 |
$128.18 |
| 36415 |
Collection of venous blood by venipuncture |
511 |
478 |
$86.56 |
| 81003 |
|
25 |
25 |
$3.16 |
| 82274 |
|
13 |
13 |
$0.00 |