| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,700 |
2,358 |
$242K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
841 |
657 |
$62K |
| 99441 |
|
426 |
318 |
$6K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
18 |
18 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
428 |
370 |
$950.24 |
| 81000 |
|
170 |
100 |
$942.39 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
102 |
91 |
$632.97 |
| J0702 |
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg |
98 |
78 |
$316.90 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
26 |
25 |
$243.48 |
| 99421 |
|
15 |
14 |
$128.13 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
150 |
120 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
111 |
97 |
$0.00 |
| 1159F |
|
12 |
12 |
$0.00 |
| 99173 |
|
33 |
30 |
$0.00 |
| 1160F |
|
12 |
12 |
$0.00 |
| A4208 |
Syringe with needle, sterile 3 cc, each |
33 |
24 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
73 |
55 |
$0.00 |
| 90686 |
|
346 |
290 |
$0.00 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
25 |
18 |
$0.00 |
| 36416 |
|
31 |
29 |
$0.00 |
| 92551 |
|
19 |
16 |
$0.00 |