| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,759 |
4,715 |
$236K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,243 |
3,369 |
$208K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
743 |
731 |
$59K |
| 95165 |
Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials |
309 |
69 |
$59K |
| 99000 |
|
4,710 |
3,981 |
$44K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
420 |
418 |
$33K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,851 |
1,387 |
$26K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
662 |
598 |
$18K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
227 |
226 |
$17K |
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
58 |
56 |
$14K |
| 97802 |
|
1,168 |
1,124 |
$13K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
818 |
754 |
$11K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
142 |
139 |
$11K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
655 |
393 |
$7K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
319 |
307 |
$5K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
82 |
82 |
$4K |
| 99441 |
|
192 |
183 |
$4K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
96 |
93 |
$1K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
14 |
14 |
$966.64 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
110 |
107 |
$778.74 |
| 99442 |
|
17 |
17 |
$480.57 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
27 |
27 |
$389.19 |
| 90473 |
|
16 |
16 |
$82.56 |
| 81001 |
|
24 |
24 |
$33.60 |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
95 |
92 |
$9.90 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
785 |
575 |
$5.08 |
| 36415 |
Collection of venous blood by venipuncture |
2,793 |
2,438 |
$0.00 |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
834 |
833 |
$0.00 |
| 90688 |
|
137 |
137 |
$0.00 |
| G0442 |
Annual alcohol misuse screening, 5 to 15 minutes |
79 |
78 |
$0.00 |
| 99172 |
|
109 |
108 |
$0.00 |
| 90686 |
|
32 |
32 |
$0.00 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
246 |
246 |
$0.00 |
| 96127 |
|
102 |
100 |
$0.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
127 |
80 |
$0.00 |
| 95024 |
|
59 |
56 |
$0.00 |
| 99402 |
|
19 |
18 |
$0.00 |
| 90651 |
|
24 |
24 |
$0.00 |
| 90696 |
|
12 |
12 |
$0.00 |
| 99401 |
|
1,261 |
1,072 |
$0.00 |
| 99071 |
|
818 |
817 |
$0.00 |
| 90633 |
|
84 |
84 |
$0.00 |
| 99173 |
|
784 |
774 |
$0.00 |
| 90715 |
|
12 |
12 |
$0.00 |
| 90710 |
|
14 |
14 |
$0.00 |
| 95144 |
|
48 |
47 |
$0.00 |
| 90670 |
|
52 |
52 |
$0.00 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
14 |
13 |
$0.00 |
| 90461 |
|
19 |
12 |
$0.00 |