| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,778 |
1,495 |
$73K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
974 |
525 |
$18K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
252 |
250 |
$13K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
181 |
170 |
$11K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
155 |
151 |
$8K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
118 |
113 |
$5K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
134 |
122 |
$4K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
59 |
59 |
$4K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
402 |
343 |
$3K |
| 99177 |
|
494 |
490 |
$2K |
| 92551 |
|
331 |
326 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
149 |
142 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
100 |
46 |
$1K |
| 83655 |
|
25 |
25 |
$224.67 |
| 96127 |
|
30 |
30 |
$113.17 |
| 90686 |
|
24 |
24 |
$90.00 |
| 90698 |
|
104 |
103 |
$80.09 |
| 90670 |
|
13 |
13 |
$80.00 |
| 36416 |
|
28 |
28 |
$79.47 |
| 81002 |
|
35 |
34 |
$75.29 |
| 99173 |
|
31 |
27 |
$74.52 |
| 85018 |
|
28 |
28 |
$49.68 |
| 96161 |
|
46 |
45 |
$43.07 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
20 |
19 |
$13.89 |
| 90461 |
|
92 |
88 |
$5.00 |
| 90671 |
|
64 |
63 |
$0.18 |
| 90680 |
|
25 |
25 |
$0.02 |
| 90633 |
|
30 |
29 |
$0.01 |
| 90656 |
|
35 |
35 |
$0.01 |
| 90744 |
|
13 |
13 |
$0.01 |
| G2211 |
Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) |
89 |
87 |
$0.00 |