| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,585 |
1,144 |
$82K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
418 |
383 |
$81K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
523 |
351 |
$31K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
723 |
428 |
$16K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
205 |
159 |
$11K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
428 |
390 |
$10K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,304 |
433 |
$8K |
| 71046 |
Radiologic examination, chest; 2 views |
341 |
310 |
$7K |
| 87430 |
|
620 |
369 |
$4K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
81 |
74 |
$3K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
62 |
55 |
$2K |
| 87807 |
|
266 |
170 |
$2K |
| 86308 |
|
236 |
230 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
45 |
41 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
16 |
13 |
$560.00 |
| 74018 |
|
30 |
30 |
$506.63 |
| 99381 |
|
20 |
14 |
$504.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
47 |
29 |
$448.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
49 |
42 |
$403.50 |
| 99173 |
|
77 |
68 |
$216.00 |
| 99401 |
|
32 |
27 |
$145.60 |
| 85018 |
|
336 |
283 |
$129.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
89 |
83 |
$117.00 |
| 81003 |
|
41 |
38 |
$105.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
18 |
13 |
$11.25 |
| 99460 |
|
18 |
14 |
$0.00 |
| 86677 |
|
15 |
15 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
47 |
43 |
$0.00 |
| 90648 |
|
14 |
13 |
$0.00 |