| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,276 |
3,939 |
$304K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,375 |
4,849 |
$268K |
| 36415 |
Collection of venous blood by venipuncture |
3,158 |
2,916 |
$9K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
465 |
444 |
$6K |
| T1013 |
Sign language or oral interpretive services, per 15 minutes |
99 |
87 |
$4K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
157 |
149 |
$3K |
| 90686 |
|
239 |
230 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
17 |
16 |
$1K |
| 80053 |
Comprehensive metabolic panel |
123 |
122 |
$1K |
| 90688 |
|
132 |
122 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
13 |
13 |
$1K |
| S0281 |
Medical home program, comprehensive care coordination and planning, maintenance of plan |
122 |
116 |
$969.72 |
| 92551 |
|
107 |
101 |
$819.14 |
| 80061 |
Lipid panel |
39 |
37 |
$508.28 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
13 |
12 |
$340.31 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
15 |
15 |
$238.00 |
| 99173 |
|
134 |
127 |
$213.78 |
| 0011A |
|
13 |
13 |
$176.18 |
| 0012A |
|
12 |
12 |
$162.20 |
| 90656 |
|
13 |
13 |
$136.73 |
| 85027 |
|
15 |
14 |
$78.35 |
| 96127 |
|
12 |
12 |
$50.40 |
| X5622 |
|
76 |
76 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
12 |
12 |
$0.00 |