| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
22,992 |
18,694 |
$1.17M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
13,424 |
10,866 |
$1.00M |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
3,980 |
3,343 |
$302K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
3,251 |
2,996 |
$265K |
| T1015 |
Clinic visit/encounter, all-inclusive |
25,841 |
19,115 |
$224K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,752 |
1,675 |
$138K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
4,860 |
4,304 |
$97K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
8,506 |
7,573 |
$95K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
914 |
880 |
$71K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
3,521 |
1,540 |
$48K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
2,799 |
2,468 |
$38K |
| 87428 |
|
951 |
856 |
$31K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
1,024 |
892 |
$30K |
| 87807 |
|
762 |
669 |
$7K |
| 90474 |
|
650 |
587 |
$7K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
458 |
309 |
$6K |
| 90670 |
|
1,683 |
1,524 |
$4K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
94 |
78 |
$3K |
| 90698 |
|
961 |
866 |
$2K |
| 99215 |
Prolong outpt/office vis |
15 |
13 |
$1K |
| 90651 |
|
339 |
303 |
$1K |
| 90680 |
|
643 |
585 |
$776.25 |
| 90656 |
|
91 |
88 |
$174.63 |
| 90686 |
|
3,013 |
2,721 |
$133.55 |
| 90744 |
|
259 |
241 |
$119.01 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
127 |
56 |
$48.56 |
| 90633 |
|
686 |
640 |
$34.05 |
| 96127 |
|
12 |
12 |
$27.16 |
| 90677 |
|
124 |
117 |
$0.00 |
| 90697 |
|
282 |
255 |
$0.00 |
| 90671 |
|
144 |
136 |
$0.00 |
| S0119 |
Ondansetron, oral, 4 mg (for circumstances falling under the medicare statute, use hcpcs q code) |
31 |
28 |
$0.00 |
| 90734 |
|
14 |
14 |
$0.00 |