| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
6,369 |
6,139 |
$1.20M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,553 |
3,425 |
$809K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
304 |
304 |
$76K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
298 |
298 |
$76K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
155 |
155 |
$39K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
634 |
634 |
$18K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
769 |
769 |
$14K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
49 |
49 |
$10K |
| 87428 |
|
80 |
79 |
$6K |
| 99309 |
Subsequent nursing facility care, per day, low to moderate complexity |
109 |
106 |
$6K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
15 |
15 |
$4K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
27 |
26 |
$2K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
34 |
34 |
$2K |
| 90474 |
|
39 |
39 |
$715.26 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
21 |
21 |
$603.52 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
16 |
15 |
$235.20 |
| 90686 |
|
34 |
34 |
$77.88 |
| 90648 |
|
25 |
25 |
$0.00 |
| 90670 |
|
244 |
244 |
$0.00 |
| 90700 |
|
95 |
95 |
$0.00 |
| 90710 |
|
15 |
15 |
$0.00 |
| 90633 |
|
15 |
15 |
$0.00 |
| 90697 |
|
12 |
12 |
$0.00 |
| 90680 |
|
39 |
39 |
$0.00 |
| 90677 |
|
12 |
12 |
$0.00 |