| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,207 |
2,618 |
$350K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
649 |
649 |
$60K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
606 |
588 |
$52K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
667 |
620 |
$51K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
329 |
329 |
$30K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,008 |
1,002 |
$18K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
668 |
668 |
$16K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
428 |
426 |
$12K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
584 |
575 |
$8K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
211 |
204 |
$7K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
45 |
45 |
$4K |
| 90474 |
|
206 |
206 |
$4K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
26 |
26 |
$4K |
| 87807 |
|
134 |
133 |
$2K |
| 99381 |
|
12 |
12 |
$1K |
| 99173 |
|
405 |
405 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
71 |
71 |
$647.27 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
12 |
12 |
$148.68 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
12 |
12 |
$5.88 |
| 90656 |
|
63 |
63 |
$0.15 |
| 90710 |
|
17 |
17 |
$0.00 |
| 90670 |
|
120 |
120 |
$0.00 |
| 90633 |
|
55 |
55 |
$0.00 |
| 90671 |
|
241 |
241 |
$0.00 |
| 90680 |
|
218 |
218 |
$0.00 |
| 90697 |
|
97 |
97 |
$0.00 |
| 90686 |
|
87 |
87 |
$0.00 |
| 90698 |
|
12 |
12 |
$0.00 |
| 90696 |
|
17 |
17 |
$0.00 |