| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
8,131 |
2,574 |
$286K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,350 |
1,798 |
$131K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,502 |
542 |
$66K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,180 |
413 |
$58K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,010 |
424 |
$48K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
272 |
117 |
$16K |
| 90461 |
|
261 |
236 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,158 |
384 |
$2K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,229 |
213 |
$2K |
| 99442 |
|
89 |
73 |
$2K |
| 90688 |
|
396 |
295 |
$1K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
924 |
783 |
$579.51 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
484 |
90 |
$477.48 |
| 87428 |
|
55 |
47 |
$477.32 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
238 |
17 |
$50.03 |
| 90734 |
|
13 |
12 |
$48.02 |
| 90670 |
|
188 |
55 |
$20.00 |
| 92551 |
|
165 |
130 |
$8.50 |
| 90648 |
|
12 |
12 |
$0.00 |
| 83655 |
|
608 |
121 |
$0.00 |
| 90633 |
|
22 |
13 |
$0.00 |
| 99173 |
|
131 |
99 |
$0.00 |
| 90700 |
|
216 |
44 |
$0.00 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
51 |
12 |
$0.00 |
| 92568 |
|
34 |
30 |
$0.00 |
| 90707 |
|
20 |
20 |
$0.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
37 |
12 |
$0.00 |
| 97802 |
|
130 |
112 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
37 |
12 |
$0.00 |
| 36416 |
|
12 |
12 |
$0.00 |
| 94760 |
|
214 |
179 |
$0.00 |
| 81001 |
|
60 |
55 |
$0.00 |
| 90698 |
|
13 |
12 |
$0.00 |
| 85018 |
|
13 |
13 |
$0.00 |
| 90716 |
|
12 |
12 |
$0.00 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
241 |
12 |
$0.00 |