| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
16,522 |
12,990 |
$493K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
6,775 |
5,609 |
$180K |
| 99497 |
|
1,674 |
1,502 |
$75K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
752 |
704 |
$67K |
| 99490 |
Ccm add 20min |
1,594 |
1,498 |
$31K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
2,516 |
1,942 |
$25K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
287 |
247 |
$12K |
| 99406 |
|
1,451 |
1,250 |
$10K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
690 |
324 |
$8K |
| G0511 |
Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral health integration services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm), per calendar month |
438 |
437 |
$7K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
247 |
195 |
$7K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
308 |
296 |
$5K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
32 |
28 |
$2K |
| 90688 |
|
106 |
106 |
$2K |
| 90756 |
|
111 |
103 |
$2K |
| 90686 |
|
85 |
83 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
125 |
111 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
16 |
15 |
$1K |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
781 |
638 |
$747.70 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
535 |
422 |
$639.04 |
| 95115 |
|
96 |
36 |
$619.34 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
27 |
24 |
$510.16 |
| 90658 |
|
34 |
32 |
$500.42 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
17 |
16 |
$404.04 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
198 |
169 |
$265.50 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
304 |
260 |
$54.34 |
| 81003 |
|
88 |
72 |
$34.02 |
| 81001 |
|
17 |
14 |
$12.45 |
| 90694 |
|
30 |
28 |
$1.64 |
| 90653 |
|
16 |
14 |
$0.00 |
| 3078F |
|
62 |
50 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
148 |
123 |
$0.00 |
| 3074F |
|
38 |
33 |
$0.00 |
| 3079F |
|
12 |
12 |
$0.00 |