| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
8,837 |
8,436 |
$657K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,600 |
3,409 |
$367K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,265 |
1,264 |
$132K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
1,275 |
1,271 |
$102K |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
2,137 |
2,127 |
$50K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
563 |
562 |
$22K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
89 |
89 |
$13K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
446 |
446 |
$9K |
| 90688 |
|
475 |
475 |
$9K |
| 71046 |
Radiologic examination, chest; 2 views |
260 |
258 |
$8K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
294 |
294 |
$6K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
37 |
37 |
$5K |
| 86580 |
|
540 |
539 |
$5K |
| 99215 |
Prolong outpt/office vis |
32 |
24 |
$5K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
37 |
37 |
$4K |
| 99383 |
|
30 |
30 |
$4K |
| 99384 |
|
18 |
18 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
30 |
28 |
$2K |
| 99051 |
|
76 |
76 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
55 |
55 |
$1K |
| D1110 |
Prophylaxis - adult |
13 |
13 |
$676.00 |
| D0120 |
Periodic oral evaluation - established patient |
14 |
14 |
$602.00 |
| 0002A |
|
12 |
12 |
$480.00 |
| D0220 |
Intraoral - periapical first radiographic image |
29 |
28 |
$435.00 |
| 96127 |
|
71 |
71 |
$428.63 |
| D0230 |
Intraoral - periapical each additional radiographic image |
31 |
24 |
$372.00 |
| 99173 |
|
53 |
53 |
$357.36 |
| 92551 |
|
39 |
39 |
$319.89 |
| 96160 |
|
42 |
42 |
$109.08 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
12 |
12 |
$108.00 |