| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
13,168 |
11,286 |
$502K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,428 |
2,105 |
$120K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
7,568 |
3,342 |
$62K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
1,113 |
632 |
$62K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
734 |
652 |
$59K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
965 |
958 |
$49K |
| 76820 |
|
1,410 |
725 |
$48K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,510 |
1,501 |
$45K |
| 76818 |
|
503 |
221 |
$44K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
670 |
460 |
$42K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
691 |
679 |
$32K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,211 |
1,194 |
$28K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
227 |
226 |
$23K |
| 81000 |
|
6,901 |
5,532 |
$21K |
| 76819 |
Fetal biophysical profile; without non-stress testing |
272 |
160 |
$19K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
398 |
382 |
$15K |
| 59430 |
|
173 |
160 |
$13K |
| 90461 |
|
2,203 |
1,861 |
$12K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
880 |
854 |
$11K |
| 76801 |
|
141 |
138 |
$11K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,654 |
1,192 |
$9K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
541 |
263 |
$7K |
| 87428 |
|
98 |
95 |
$6K |
| 83655 |
|
327 |
316 |
$3K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
302 |
283 |
$3K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
125 |
125 |
$3K |
| 99381 |
|
40 |
37 |
$2K |
| 59025 |
Fetal non-stress test |
73 |
51 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
38 |
38 |
$2K |
| 99235 |
|
15 |
15 |
$2K |
| 99382 |
|
60 |
60 |
$2K |
| 92551 |
|
685 |
683 |
$1K |
| 88305 |
Level IV - Surgical pathology, gross and microscopic examination |
69 |
68 |
$1K |
| J0561 |
Injection, penicillin g benzathine, 100,000 units |
12 |
12 |
$902.40 |
| 90715 |
|
83 |
81 |
$602.33 |
| 81025 |
|
96 |
88 |
$577.11 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
12 |
12 |
$574.03 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
72 |
68 |
$440.98 |
| 99383 |
|
13 |
13 |
$332.12 |
| 87807 |
|
27 |
27 |
$286.00 |
| 90651 |
|
138 |
137 |
$244.67 |
| 90688 |
|
18 |
17 |
$216.72 |
| 81002 |
|
59 |
55 |
$148.92 |
| 90707 |
|
38 |
38 |
$88.20 |
| 81003 |
|
85 |
83 |
$82.46 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
28 |
26 |
$40.47 |
| 90686 |
|
1,267 |
1,254 |
$17.93 |
| 85018 |
|
26 |
26 |
$15.92 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
13 |
13 |
$14.56 |
| 96160 |
|
14 |
14 |
$6.99 |
| 90710 |
|
70 |
70 |
$0.00 |
| 90670 |
|
1,179 |
1,167 |
$0.00 |
| 99173 |
|
701 |
695 |
$0.00 |
| 90648 |
|
796 |
790 |
$0.00 |
| 90633 |
|
391 |
390 |
$0.00 |
| 90681 |
|
280 |
280 |
$0.00 |
| 90734 |
|
131 |
124 |
$0.00 |
| 90700 |
|
43 |
42 |
$0.00 |
| 90723 |
|
389 |
386 |
$0.00 |
| 90716 |
|
37 |
37 |
$0.00 |
| 90696 |
|
54 |
54 |
$0.00 |
| 90698 |
|
52 |
52 |
$0.00 |
| 91301 |
|
13 |
13 |
$0.00 |