| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,965 |
4,753 |
$179K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,522 |
2,592 |
$143K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
472 |
401 |
$29K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
381 |
341 |
$16K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,269 |
455 |
$12K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
895 |
421 |
$11K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
137 |
129 |
$9K |
| 99000 |
|
1,112 |
915 |
$9K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
636 |
621 |
$6K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
120 |
118 |
$6K |
| 81002 |
|
1,994 |
1,375 |
$5K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
50 |
49 |
$4K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
288 |
278 |
$4K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
348 |
303 |
$4K |
| 59430 |
|
27 |
24 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
35 |
31 |
$2K |
| 81025 |
|
351 |
334 |
$2K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
290 |
264 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
15 |
15 |
$1K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
110 |
101 |
$877.93 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
16 |
14 |
$831.60 |
| 59020 |
|
13 |
13 |
$274.56 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
99 |
91 |
$141.44 |
| 90670 |
|
192 |
190 |
$0.00 |
| 90723 |
|
25 |
25 |
$0.00 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
66 |
64 |
$0.00 |