| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
16,450 |
13,289 |
$932K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
9,121 |
7,704 |
$764K |
| 99199 |
Unlisted special service, procedure or report |
129,143 |
78,538 |
$737K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,770 |
2,345 |
$238K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
2,634 |
2,248 |
$229K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
2,110 |
1,698 |
$185K |
| 99215 |
Prolong outpt/office vis |
1,575 |
1,369 |
$168K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,867 |
1,657 |
$164K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
8,856 |
7,622 |
$158K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
4,470 |
3,884 |
$140K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
5,659 |
4,831 |
$135K |
| 95165 |
Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials |
329 |
65 |
$70K |
| 92567 |
|
6,783 |
5,649 |
$57K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
4,524 |
3,901 |
$56K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
10,719 |
8,598 |
$55K |
| D0145 |
Oral evaluation for a patient under three years of age |
1,598 |
1,343 |
$49K |
| 96127 |
|
10,065 |
8,354 |
$33K |
| 88738 |
|
4,442 |
3,767 |
$24K |
| D1206 |
Topical application of fluoride varnish |
1,611 |
1,347 |
$22K |
| 80061 |
Lipid panel |
1,508 |
1,129 |
$18K |
| 87807 |
|
1,282 |
1,091 |
$16K |
| 90474 |
|
616 |
565 |
$12K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,188 |
902 |
$10K |
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
65 |
49 |
$10K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
3,512 |
2,676 |
$5K |
| 80048 |
Basic metabolic panel (calcium, ionized) |
692 |
501 |
$5K |
| 90651 |
|
838 |
693 |
$4K |
| 81002 |
|
7,607 |
6,186 |
$4K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
262 |
216 |
$4K |
| 95117 |
|
382 |
155 |
$3K |
| 96161 |
|
833 |
737 |
$3K |
| 99381 |
|
31 |
27 |
$2K |
| 96111 |
|
22 |
22 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
109 |
107 |
$2K |
| 92551 |
|
7,087 |
5,827 |
$2K |
| 90734 |
|
521 |
398 |
$2K |
| 36415 |
Collection of venous blood by venipuncture |
701 |
565 |
$1K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
19 |
12 |
$1K |
| 99173 |
|
7,415 |
6,105 |
$1K |
| 83655 |
|
239 |
201 |
$743.20 |
| 90686 |
|
2,764 |
2,419 |
$740.64 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
37 |
24 |
$535.85 |
| 90697 |
|
377 |
324 |
$416.16 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
104 |
87 |
$260.85 |
| 90670 |
|
1,693 |
1,507 |
$224.49 |
| 90620 |
|
108 |
91 |
$206.56 |
| 90715 |
|
183 |
152 |
$185.46 |
| 90619 |
|
154 |
134 |
$160.06 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
210 |
198 |
$153.93 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
14 |
13 |
$132.34 |
| 81025 |
|
16 |
12 |
$78.91 |
| 36416 |
|
650 |
508 |
$37.92 |
| 90633 |
|
675 |
581 |
$34.10 |
| 94760 |
|
133 |
106 |
$6.41 |
| 90710 |
|
614 |
534 |
$0.00 |
| 83525 |
|
169 |
121 |
$0.00 |
| 90658 |
|
345 |
318 |
$0.00 |
| 84439 |
|
170 |
122 |
$0.00 |
| 90671 |
|
128 |
121 |
$0.00 |
| 90685 |
|
108 |
98 |
$0.00 |
| 84481 |
|
169 |
121 |
$0.00 |
| 90707 |
|
19 |
13 |
$0.00 |
| 90700 |
|
53 |
44 |
$0.00 |
| 90698 |
|
409 |
393 |
$0.00 |
| 90647 |
|
195 |
172 |
$0.00 |
| 90680 |
|
692 |
623 |
$0.00 |
| 90696 |
|
88 |
68 |
$0.00 |
| 90744 |
|
152 |
149 |
$0.00 |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
170 |
121 |
$0.00 |
| 84443 |
Thyroid stimulating hormone (TSH) |
171 |
122 |
$0.00 |
| 90723 |
|
18 |
16 |
$0.00 |