| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,524 |
2,810 |
$184K |
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
263 |
237 |
$27K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
223 |
204 |
$12K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
104 |
66 |
$4K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
62 |
49 |
$4K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
50 |
46 |
$4K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
104 |
86 |
$4K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
270 |
208 |
$2K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
22 |
20 |
$714.25 |
| 96127 |
|
104 |
73 |
$191.81 |
| 0071A |
|
14 |
12 |
$147.87 |
| 92551 |
|
29 |
29 |
$121.59 |
| 86580 |
|
23 |
21 |
$113.61 |
| 99173 |
|
62 |
61 |
$57.64 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
66 |
56 |
$26.75 |
| 99490 |
Ccm add 20min |
51 |
47 |
$23.73 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
18 |
12 |
$12.86 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
13 |
12 |
$11.22 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
14 |
13 |
$0.00 |