| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,523 |
2,173 |
$323K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
596 |
523 |
$57K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,322 |
956 |
$43K |
| 99215 |
Prolong outpt/office vis |
181 |
166 |
$28K |
| 96127 |
|
2,032 |
1,649 |
$20K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
120 |
106 |
$13K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
128 |
90 |
$11K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
38 |
38 |
$5K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
60 |
52 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
15 |
15 |
$2K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
39 |
37 |
$2K |
| 90686 |
|
263 |
220 |
$811.11 |
| 99382 |
|
17 |
12 |
$729.31 |
| 90682 |
|
13 |
12 |
$727.81 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
38 |
37 |
$595.45 |
| 90461 |
|
140 |
66 |
$506.50 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
25 |
24 |
$490.36 |
| 0031A |
|
36 |
12 |
$480.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
26 |
25 |
$213.62 |
| 80061 |
Lipid panel |
13 |
13 |
$147.29 |
| 90656 |
|
13 |
13 |
$111.00 |
| 36416 |
|
26 |
25 |
$0.00 |
| 91303 |
|
23 |
12 |
$0.00 |
| 99000 |
|
14 |
13 |
$0.00 |
| 90670 |
|
24 |
24 |
$0.00 |