| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
12,805 |
9,801 |
$590K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
7,559 |
6,419 |
$293K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,417 |
1,664 |
$122K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
800 |
345 |
$28K |
| G0467 |
Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit |
7,532 |
6,419 |
$23K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
915 |
833 |
$13K |
| 97803 |
|
1,607 |
1,159 |
$9K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
205 |
120 |
$9K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
122 |
87 |
$3K |
| 92081 |
|
176 |
105 |
$2K |
| 82962 |
|
410 |
388 |
$1K |
| 99406 |
|
167 |
145 |
$1K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
637 |
553 |
$1K |
| 99173 |
|
16 |
13 |
$841.05 |
| D7140 |
Extraction, erupted tooth or exposed root |
14 |
12 |
$779.48 |
| D0140 |
Limited oral evaluation - problem focused |
52 |
40 |
$764.61 |
| 92551 |
|
269 |
145 |
$747.60 |
| 99051 |
|
14 |
14 |
$686.60 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
20 |
12 |
$678.75 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
485 |
431 |
$467.25 |
| 0011A |
|
52 |
39 |
$327.88 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
520 |
476 |
$280.35 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
51 |
50 |
$253.30 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
19 |
19 |
$244.56 |
| 85018 |
|
290 |
155 |
$202.74 |
| 80053 |
Comprehensive metabolic panel |
30 |
29 |
$145.29 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
67 |
67 |
$61.60 |
| G0008 |
Administration of influenza virus vaccine |
111 |
109 |
$47.55 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
116 |
109 |
$32.37 |
| 1158F |
|
596 |
517 |
$0.00 |
| 3077F |
|
379 |
339 |
$0.00 |
| 3725F |
|
677 |
571 |
$0.00 |
| 3078F |
|
660 |
583 |
$0.00 |
| 3288F |
|
326 |
284 |
$0.00 |
| 1160F |
|
1,026 |
875 |
$0.00 |
| 1159F |
|
1,056 |
897 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
360 |
269 |
$0.00 |
| Q2037 |
Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluvirin) |
111 |
109 |
$0.00 |
| 81002 |
|
14 |
14 |
$0.00 |
| 99401 |
|
29 |
15 |
$0.00 |
| 81003 |
|
29 |
24 |
$0.00 |
| G0468 |
Federally qualified health center (fqhc) visit, ippe or awv; a fqhc visit that includes an initial preventive physical examination (ippe) or annual wellness visit (awv) and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving an ippe or awv |
68 |
68 |
$0.00 |
| 1125F |
|
421 |
374 |
$0.00 |
| 3079F |
|
386 |
343 |
$0.00 |
| 1101F |
|
331 |
285 |
$0.00 |
| 1170F |
|
599 |
519 |
$0.00 |
| 3008F |
|
1,095 |
931 |
$0.00 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
62 |
61 |
$0.00 |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
442 |
402 |
$0.00 |
| 3075F |
|
163 |
140 |
$0.00 |
| 99000 |
|
39 |
39 |
$0.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
28 |
25 |
$0.00 |
| 3074F |
|
483 |
433 |
$0.00 |
| 1126F |
|
33 |
30 |
$0.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
15 |
15 |
$0.00 |
| J1010 |
Injection, methylprednisolone acetate, 1 mg |
27 |
25 |
$0.00 |
| 90656 |
|
21 |
21 |
$0.00 |