| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
21,609 |
15,401 |
$778K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
13,455 |
9,845 |
$415K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
5,647 |
3,745 |
$65K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
1,918 |
1,559 |
$55K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
952 |
834 |
$50K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
4,391 |
1,862 |
$49K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
2,857 |
2,404 |
$32K |
| 95117 |
|
2,480 |
651 |
$19K |
| 82044 |
|
3,594 |
3,092 |
$14K |
| 94200 |
|
1,136 |
860 |
$12K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,776 |
1,490 |
$10K |
| 80305 |
|
1,756 |
1,467 |
$9K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
90 |
81 |
$7K |
| 95165 |
Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials |
41 |
39 |
$6K |
| 36415 |
Collection of venous blood by venipuncture |
3,004 |
2,470 |
$6K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
97 |
82 |
$6K |
| 99401 |
|
1,348 |
1,072 |
$3K |
| 90674 |
|
229 |
201 |
$2K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
732 |
591 |
$2K |
| 93000 |
|
169 |
148 |
$2K |
| 81002 |
|
3,987 |
3,138 |
$2K |
| 99215 |
Prolong outpt/office vis |
53 |
41 |
$1K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
114 |
88 |
$1K |
| 90756 |
|
112 |
107 |
$1K |
| 99406 |
|
242 |
199 |
$1K |
| 99497 |
|
360 |
304 |
$1K |
| 3078F |
|
2,612 |
2,199 |
$1K |
| 3074F |
|
2,656 |
2,242 |
$1K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
57 |
45 |
$912.76 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
16 |
12 |
$889.49 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
14 |
12 |
$791.95 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
523 |
425 |
$648.60 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
102 |
90 |
$585.70 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
3,295 |
2,694 |
$567.27 |
| 81025 |
|
81 |
64 |
$489.67 |
| 3079F |
|
1,091 |
914 |
$451.22 |
| 96160 |
|
369 |
312 |
$434.96 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
269 |
226 |
$403.40 |
| 90686 |
|
17 |
16 |
$197.12 |
| 3075F |
|
378 |
313 |
$120.00 |
| 3077F |
|
137 |
117 |
$100.00 |
| 1159F |
|
581 |
479 |
$61.77 |
| 1160F |
|
577 |
471 |
$61.77 |
| 99397 |
|
63 |
52 |
$32.80 |
| 1126F |
|
159 |
132 |
$30.00 |
| G0008 |
Administration of influenza virus vaccine |
145 |
135 |
$25.54 |
| 3044F |
|
823 |
687 |
$12.42 |
| 1158F |
|
225 |
184 |
$11.77 |
| 1170F |
|
363 |
305 |
$11.76 |
| 3080F |
|
15 |
12 |
$10.00 |
| 1125F |
|
44 |
29 |
$1.77 |
| 3045F |
|
12 |
12 |
$0.00 |
| 2014F |
|
239 |
197 |
$0.00 |
| 1124F |
|
247 |
210 |
$0.00 |
| 1101F |
|
159 |
130 |
$0.00 |
| 1220F |
|
227 |
186 |
$0.00 |