| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
11,675 |
9,235 |
$246K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,418 |
2,236 |
$71K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,076 |
1,071 |
$34K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,848 |
1,697 |
$29K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
311 |
311 |
$22K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
205 |
205 |
$21K |
| 99215 |
Prolong outpt/office vis |
493 |
469 |
$21K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
1,187 |
1,185 |
$20K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
254 |
253 |
$19K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
1,780 |
1,516 |
$17K |
| J3490 |
Unclassified drugs |
204 |
204 |
$15K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
182 |
182 |
$6K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
60 |
57 |
$3K |
| 87428 |
|
558 |
512 |
$645.13 |
| 92552 |
|
641 |
638 |
$435.63 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
156 |
133 |
$149.46 |
| 90686 |
|
542 |
535 |
$137.18 |
| 85018 |
|
1,058 |
1,053 |
$91.61 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
195 |
191 |
$84.59 |
| 99173 |
|
643 |
640 |
$67.47 |
| 81003 |
|
989 |
959 |
$64.25 |
| 81025 |
|
469 |
442 |
$44.10 |
| D1206 |
Topical application of fluoride varnish |
227 |
227 |
$35.64 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
258 |
245 |
$35.46 |
| 90700 |
|
110 |
110 |
$30.70 |
| 93000 |
|
38 |
37 |
$28.41 |
| 86580 |
|
585 |
573 |
$23.00 |
| 90707 |
|
86 |
85 |
$9.00 |
| 90715 |
|
91 |
91 |
$9.00 |
| 90734 |
|
93 |
93 |
$9.00 |
| 90670 |
|
69 |
66 |
$9.00 |
| 90648 |
|
83 |
80 |
$9.00 |
| 90713 |
|
35 |
35 |
$9.00 |
| 90651 |
|
134 |
134 |
$9.00 |
| 90716 |
|
86 |
85 |
$9.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
58 |
57 |
$6.29 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
15 |
12 |
$0.56 |
| 90633 |
|
66 |
65 |
$0.00 |
| 90620 |
|
45 |
45 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
18 |
17 |
$0.00 |
| 90688 |
|
25 |
25 |
$0.00 |
| 90723 |
|
13 |
12 |
$0.00 |