| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,291 |
4,092 |
$187K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,080 |
2,611 |
$166K |
| 99336 |
|
884 |
732 |
$24K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,539 |
1,315 |
$16K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
392 |
327 |
$12K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
111 |
98 |
$8K |
| 99335 |
|
263 |
207 |
$4K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
318 |
146 |
$3K |
| J0702 |
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg |
353 |
303 |
$3K |
| 36415 |
Collection of venous blood by venipuncture |
1,922 |
1,782 |
$2K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
19 |
19 |
$2K |
| 99384 |
|
22 |
19 |
$2K |
| 92551 |
|
237 |
194 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
138 |
113 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
83 |
82 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
199 |
150 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
13 |
13 |
$972.88 |
| 99401 |
|
83 |
73 |
$935.52 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
12 |
12 |
$765.33 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
380 |
336 |
$458.00 |
| 99173 |
|
240 |
194 |
$456.50 |
| 99497 |
|
54 |
49 |
$305.32 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
24 |
21 |
$242.21 |
| 90686 |
|
20 |
20 |
$113.89 |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
17 |
16 |
$79.92 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
187 |
178 |
$51.07 |
| 81002 |
|
25 |
24 |
$45.75 |
| 84443 |
Thyroid stimulating hormone (TSH) |
19 |
18 |
$37.80 |
| 80061 |
Lipid panel |
19 |
18 |
$36.18 |
| 83525 |
|
22 |
21 |
$30.90 |
| 80053 |
Comprehensive metabolic panel |
23 |
22 |
$28.50 |
| 84681 |
|
22 |
21 |
$28.11 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
23 |
21 |
$26.22 |
| 82977 |
|
22 |
21 |
$19.44 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
22 |
21 |
$17.50 |
| 81003 |
|
20 |
16 |
$15.96 |
| 82248 |
|
22 |
21 |
$13.56 |
| 84550 |
|
22 |
21 |
$12.24 |
| 90734 |
|
18 |
17 |
$0.01 |
| 94760 |
|
24 |
21 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
52 |
51 |
$0.00 |
| 90715 |
|
13 |
12 |
$0.00 |