| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
9,937 |
7,319 |
$362K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
1,840 |
1,609 |
$72K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
748 |
725 |
$61K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
756 |
739 |
$60K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
862 |
769 |
$44K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
477 |
448 |
$35K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
3,044 |
1,384 |
$31K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,909 |
953 |
$25K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
3,544 |
3,254 |
$22K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
676 |
616 |
$16K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
70 |
69 |
$5K |
| 90461 |
|
403 |
307 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
201 |
183 |
$3K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
28 |
27 |
$2K |
| 0071A |
|
51 |
51 |
$1K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
113 |
107 |
$1K |
| 0001A |
|
33 |
33 |
$825.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
22 |
21 |
$628.57 |
| 0002A |
|
18 |
18 |
$450.00 |
| 87807 |
|
30 |
30 |
$330.00 |
| 96160 |
|
119 |
119 |
$215.28 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
72 |
68 |
$20.16 |
| 97802 |
|
931 |
923 |
$0.74 |
| G9716 |
Bmi is documented as being outside of normal parameters, follow-up plan is not completed for documented medical reason |
599 |
586 |
$0.30 |
| 90658 |
|
348 |
343 |
$0.13 |
| 90686 |
|
41 |
41 |
$0.01 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
213 |
198 |
$0.00 |
| 91307 |
|
72 |
62 |
$0.00 |
| 90651 |
|
24 |
24 |
$0.00 |
| 90648 |
|
26 |
26 |
$0.00 |
| 91300 |
|
80 |
73 |
$0.00 |
| 90670 |
|
75 |
74 |
$0.00 |
| 90734 |
|
12 |
12 |
$0.00 |