| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
12,777 |
10,219 |
$602K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
5,000 |
4,880 |
$166K |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
1,749 |
1,746 |
$144K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
3,067 |
3,015 |
$100K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,102 |
1,101 |
$75K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,210 |
1,203 |
$74K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,003 |
1,002 |
$65K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
809 |
809 |
$62K |
| 92567 |
|
5,264 |
4,716 |
$53K |
| 92552 |
|
2,700 |
2,700 |
$53K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
806 |
793 |
$50K |
| 94680 |
|
1,346 |
1,247 |
$47K |
| 87428 |
|
714 |
661 |
$29K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
2,709 |
2,522 |
$20K |
| 86580 |
|
2,955 |
2,945 |
$16K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
3,057 |
3,044 |
$15K |
| 92587 |
|
687 |
686 |
$15K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
474 |
250 |
$7K |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
614 |
584 |
$6K |
| 94667 |
|
531 |
469 |
$6K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
548 |
482 |
$6K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
193 |
183 |
$5K |
| G0438 |
Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit |
41 |
41 |
$4K |
| 99173 |
|
1,800 |
1,799 |
$3K |
| 94010 |
|
47 |
47 |
$1K |
| 0071A |
|
30 |
30 |
$1K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
12 |
12 |
$1K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
12 |
12 |
$986.40 |
| 0001A |
|
17 |
17 |
$680.00 |
| 0072A |
|
16 |
16 |
$640.00 |
| 87807 |
|
127 |
116 |
$635.08 |
| 0002A |
|
16 |
16 |
$600.00 |
| 81002 |
|
272 |
271 |
$494.60 |
| 90461 |
|
29 |
28 |
$330.00 |
| 81000 |
|
65 |
65 |
$213.37 |
| 90686 |
|
33 |
33 |
$125.14 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
287 |
254 |
$105.37 |
| 94760 |
|
486 |
443 |
$2.80 |
| A4206 |
Syringe with needle, sterile, 1 cc or less, each |
637 |
609 |
$0.95 |
| 90734 |
|
12 |
12 |
$0.00 |
| 99000 |
|
133 |
123 |
$0.00 |