| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,512 |
4,984 |
$224K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,808 |
4,312 |
$147K |
| 95165 |
Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials |
230 |
213 |
$73K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
437 |
416 |
$31K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
2,337 |
2,204 |
$28K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
3,102 |
1,291 |
$27K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
277 |
248 |
$19K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
305 |
280 |
$15K |
| 87428 |
|
422 |
395 |
$14K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
154 |
151 |
$12K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
360 |
337 |
$8K |
| 99215 |
Prolong outpt/office vis |
173 |
160 |
$8K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
551 |
502 |
$7K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
64 |
64 |
$6K |
| 90461 |
|
857 |
690 |
$5K |
| 95117 |
|
552 |
193 |
$5K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
42 |
40 |
$3K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
183 |
170 |
$3K |
| 81025 |
|
383 |
332 |
$2K |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
27 |
27 |
$2K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
52 |
52 |
$2K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
39 |
38 |
$1K |
| 0002A |
|
69 |
69 |
$1K |
| 81003 |
|
538 |
437 |
$898.05 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
32 |
31 |
$760.74 |
| 0001A |
|
80 |
80 |
$694.54 |
| 87807 |
|
64 |
58 |
$629.79 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
17 |
16 |
$521.54 |
| 0071A |
|
13 |
13 |
$480.00 |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
19 |
19 |
$348.58 |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
140 |
123 |
$281.66 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
19 |
19 |
$59.98 |
| 90686 |
|
13 |
13 |
$57.78 |
| 90688 |
|
62 |
62 |
$18.06 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
16 |
16 |
$7.68 |
| 91300 |
|
38 |
35 |
$0.04 |
| 91307 |
|
16 |
15 |
$0.02 |
| 90681 |
|
25 |
25 |
$0.00 |
| 90648 |
|
12 |
12 |
$0.00 |
| 90670 |
|
309 |
290 |
$0.00 |
| 90734 |
|
27 |
26 |
$0.00 |
| 90710 |
|
16 |
16 |
$0.00 |
| 90633 |
|
14 |
14 |
$0.00 |
| 99497 |
|
16 |
13 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
70 |
70 |
$0.00 |
| 90698 |
|
86 |
83 |
$0.00 |
| 90744 |
|
27 |
27 |
$0.00 |