| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,476 |
2,176 |
$70K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,309 |
1,167 |
$50K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
398 |
382 |
$29K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
320 |
316 |
$23K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
35 |
34 |
$20K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,226 |
795 |
$16K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
76 |
74 |
$6K |
| 90461 |
|
627 |
539 |
$5K |
| 0001A |
|
113 |
111 |
$4K |
| 76817 |
Ultrasound, pregnant uterus, real time with image documentation, transvaginal |
55 |
52 |
$4K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
498 |
483 |
$3K |
| 0002A |
|
81 |
81 |
$3K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
370 |
202 |
$3K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
79 |
50 |
$2K |
| 59430 |
|
28 |
26 |
$2K |
| 81002 |
|
682 |
540 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
33 |
32 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
146 |
130 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
33 |
31 |
$2K |
| 81003 |
|
885 |
661 |
$1K |
| 95117 |
|
279 |
97 |
$1K |
| 58300 |
|
13 |
13 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
24 |
17 |
$935.08 |
| 90715 |
|
102 |
100 |
$756.00 |
| 90658 |
|
88 |
85 |
$402.00 |
| 0011A |
|
14 |
14 |
$280.00 |
| 0012A |
|
12 |
12 |
$240.00 |
| 90686 |
|
52 |
51 |
$221.41 |
| 81025 |
|
26 |
25 |
$187.98 |
| 0031A |
|
23 |
23 |
$141.95 |
| 90688 |
|
41 |
40 |
$18.06 |
| 3078F |
|
2,991 |
2,580 |
$0.00 |
| 90670 |
|
368 |
360 |
$0.00 |
| 90633 |
|
87 |
87 |
$0.00 |
| 90655 |
|
14 |
14 |
$0.00 |
| 90700 |
|
35 |
34 |
$0.00 |
| 90648 |
|
69 |
67 |
$0.00 |
| 90710 |
|
64 |
64 |
$0.00 |
| 90734 |
|
57 |
56 |
$0.00 |
| 90707 |
|
30 |
30 |
$0.00 |
| 90680 |
|
111 |
108 |
$0.00 |
| 90698 |
|
123 |
121 |
$0.00 |
| 3074F |
|
3,477 |
2,978 |
$0.00 |
| 90696 |
|
23 |
23 |
$0.00 |
| 90651 |
|
34 |
34 |
$0.00 |
| 3079F |
|
480 |
421 |
$0.00 |
| 90723 |
|
12 |
12 |
$0.00 |
| 3075F |
|
36 |
33 |
$0.00 |
| 90716 |
|
29 |
29 |
$0.00 |
| 90743 |
|
13 |
13 |
$0.00 |