| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
7,038 |
6,083 |
$460K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,132 |
3,837 |
$186K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,067 |
1,035 |
$69K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
781 |
736 |
$54K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
745 |
724 |
$48K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,691 |
2,524 |
$35K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,255 |
1,171 |
$18K |
| 92551 |
|
2,385 |
2,258 |
$18K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
227 |
209 |
$13K |
| 96127 |
|
4,627 |
3,957 |
$6K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,003 |
881 |
$6K |
| 99173 |
|
2,653 |
2,516 |
$5K |
| 96160 |
|
1,275 |
1,095 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
194 |
84 |
$1K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
539 |
370 |
$1K |
| 90474 |
|
27 |
26 |
$228.25 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
15 |
14 |
$183.82 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
25 |
13 |
$124.16 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
383 |
297 |
$5.80 |
| 90633 |
|
106 |
103 |
$0.00 |
| 90649 |
|
63 |
63 |
$0.00 |
| 90648 |
|
15 |
13 |
$0.00 |
| 90670 |
|
174 |
163 |
$0.00 |
| 90734 |
|
27 |
27 |
$0.00 |
| 90671 |
|
45 |
39 |
$0.00 |
| 90710 |
|
12 |
12 |
$0.00 |
| 90621 |
|
16 |
12 |
$0.00 |
| 90715 |
|
13 |
13 |
$0.00 |
| 90686 |
|
331 |
325 |
$0.00 |
| 90680 |
|
27 |
25 |
$0.00 |
| 90674 |
|
356 |
338 |
$0.00 |
| 90698 |
|
48 |
48 |
$0.00 |
| 90619 |
|
46 |
43 |
$0.00 |