| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
570 |
511 |
$27K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
788 |
695 |
$23K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
888 |
765 |
$19K |
| 99442 |
|
264 |
233 |
$12K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
288 |
270 |
$11K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
233 |
219 |
$11K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
185 |
175 |
$9K |
| 90461 |
|
218 |
207 |
$9K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
89 |
82 |
$4K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
135 |
122 |
$2K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
65 |
61 |
$1K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
13 |
13 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
93 |
42 |
$938.50 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
13 |
13 |
$809.16 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
78 |
71 |
$807.97 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
32 |
31 |
$772.48 |
| 96127 |
|
123 |
116 |
$495.67 |
| 96161 |
|
192 |
168 |
$411.48 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
218 |
198 |
$173.86 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
34 |
31 |
$70.35 |
| 90677 |
|
72 |
71 |
$0.00 |
| 90680 |
|
15 |
14 |
$0.00 |
| 90697 |
|
14 |
14 |
$0.00 |
| 90698 |
|
13 |
13 |
$0.00 |