| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
8,935 |
6,880 |
$306K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,801 |
3,149 |
$185K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
643 |
627 |
$47K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
517 |
512 |
$39K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,905 |
1,274 |
$31K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
273 |
260 |
$19K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
465 |
426 |
$19K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
263 |
259 |
$17K |
| 92557 |
|
556 |
553 |
$17K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,194 |
1,108 |
$16K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,098 |
523 |
$15K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
1,019 |
948 |
$7K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
878 |
869 |
$7K |
| 92552 |
|
248 |
244 |
$6K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
113 |
105 |
$5K |
| 99429 |
|
166 |
165 |
$4K |
| 99051 |
|
285 |
267 |
$4K |
| 92551 |
|
371 |
363 |
$3K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
125 |
115 |
$1K |
| 90461 |
|
2,004 |
517 |
$1K |
| 81003 |
|
221 |
200 |
$406.35 |
| 96160 |
|
408 |
406 |
$223.84 |
| 87807 |
|
13 |
12 |
$143.00 |
| 96161 |
|
758 |
754 |
$115.18 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
14 |
14 |
$7.14 |
| 90686 |
|
227 |
227 |
$0.10 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
53 |
47 |
$0.00 |
| 96127 |
|
26 |
25 |
$0.00 |
| 90656 |
|
12 |
12 |
$0.00 |
| 90670 |
|
103 |
103 |
$0.00 |
| 90648 |
|
80 |
80 |
$0.00 |