| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
6,827 |
5,900 |
$656K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,968 |
1,967 |
$183K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,914 |
1,802 |
$166K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,699 |
1,591 |
$108K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
2,282 |
2,279 |
$76K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
3,370 |
3,349 |
$60K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
471 |
471 |
$44K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,358 |
1,331 |
$36K |
| 59400 |
Routine obstetric care including antepartum care, vaginal delivery, and postpartum care |
12 |
12 |
$21K |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
150 |
150 |
$16K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
619 |
613 |
$9K |
| 87807 |
|
647 |
628 |
$7K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
62 |
62 |
$6K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
56 |
56 |
$5K |
| 76801 |
|
37 |
37 |
$4K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
77 |
77 |
$3K |
| 99381 |
|
26 |
26 |
$2K |
| 90474 |
|
109 |
109 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
186 |
186 |
$1K |
| 99173 |
|
574 |
574 |
$1K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
13 |
13 |
$1K |
| 90473 |
|
27 |
27 |
$495.18 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
14 |
14 |
$174.62 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
12 |
12 |
$5.94 |
| 90648 |
|
255 |
255 |
$0.00 |
| 90633 |
|
346 |
346 |
$0.00 |
| 90700 |
|
13 |
13 |
$0.00 |
| 90670 |
|
710 |
710 |
$0.00 |
| 90687 |
|
81 |
79 |
$0.00 |
| 90710 |
|
27 |
27 |
$0.00 |
| 90707 |
|
24 |
24 |
$0.00 |
| 90716 |
|
15 |
15 |
$0.00 |
| 90680 |
|
449 |
449 |
$0.00 |
| 90697 |
|
81 |
81 |
$0.00 |
| 90688 |
|
213 |
213 |
$0.00 |
| 90723 |
|
133 |
133 |
$0.00 |
| 90698 |
|
24 |
24 |
$0.00 |
| 90696 |
|
13 |
13 |
$0.00 |