| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
25,668 |
21,699 |
$880K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
3,021 |
2,402 |
$197K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
2,626 |
2,075 |
$173K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,898 |
2,267 |
$171K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
13,671 |
5,520 |
$164K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
11,562 |
10,685 |
$144K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,148 |
1,725 |
$133K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
1,750 |
1,713 |
$63K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,336 |
1,221 |
$62K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
4,868 |
2,499 |
$61K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
1,127 |
1,032 |
$45K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
999 |
945 |
$27K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
3,074 |
2,135 |
$21K |
| 70486 |
|
145 |
130 |
$9K |
| D7240 |
Removal of impacted tooth - completely bony |
45 |
12 |
$7K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
149 |
143 |
$7K |
| 90461 |
|
3,679 |
2,833 |
$7K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
948 |
422 |
$4K |
| 92551 |
|
3,545 |
2,538 |
$4K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
58 |
56 |
$4K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
42 |
38 |
$3K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
863 |
240 |
$3K |
| 96161 |
|
1,386 |
1,334 |
$3K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
101 |
86 |
$2K |
| 99173 |
|
4,790 |
3,575 |
$2K |
| 87807 |
|
171 |
163 |
$2K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
113 |
109 |
$1K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
127 |
104 |
$1K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
34 |
31 |
$1K |
| 99460 |
|
12 |
12 |
$1K |
| D0330 |
Panoramic radiographic image |
19 |
17 |
$956.70 |
| 83655 |
|
91 |
76 |
$676.22 |
| D9239 |
|
13 |
13 |
$513.36 |
| G0402 |
Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment |
16 |
16 |
$400.00 |
| 90670 |
|
1,905 |
1,570 |
$225.34 |
| 81002 |
|
40 |
29 |
$84.68 |
| 81025 |
|
13 |
12 |
$79.53 |
| 96160 |
|
26 |
25 |
$60.72 |
| 85018 |
|
37 |
37 |
$19.32 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
33 |
30 |
$16.51 |
| 90656 |
|
606 |
599 |
$1.16 |
| 90651 |
|
533 |
507 |
$0.30 |
| 90620 |
|
250 |
245 |
$0.20 |
| 90734 |
|
379 |
281 |
$0.18 |
| 90686 |
|
874 |
750 |
$0.18 |
| 90633 |
|
544 |
429 |
$0.13 |
| 90648 |
|
660 |
531 |
$0.11 |
| 90681 |
|
29 |
29 |
$0.03 |
| 90700 |
|
86 |
82 |
$0.02 |
| 90680 |
|
545 |
461 |
$0.02 |
| 90723 |
|
133 |
104 |
$0.01 |
| 90715 |
|
26 |
26 |
$0.00 |
| 90710 |
|
36 |
25 |
$0.00 |
| D0601 |
|
58 |
48 |
$0.00 |
| 90698 |
|
55 |
39 |
$0.00 |
| 96127 |
|
627 |
367 |
$0.00 |
| 90696 |
|
26 |
14 |
$0.00 |
| 36416 |
|
22 |
14 |
$0.00 |