| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,332 |
1,062 |
$89K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
774 |
672 |
$35K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
182 |
175 |
$12K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
181 |
173 |
$12K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
148 |
136 |
$9K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
749 |
584 |
$9K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
508 |
484 |
$7K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
76 |
68 |
$6K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
661 |
599 |
$5K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
68 |
66 |
$4K |
| 80061 |
Lipid panel |
353 |
336 |
$4K |
| 99215 |
Prolong outpt/office vis |
44 |
38 |
$4K |
| 92551 |
|
453 |
431 |
$3K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
234 |
222 |
$3K |
| 82947 |
|
353 |
337 |
$1K |
| 86308 |
|
159 |
156 |
$757.05 |
| 99173 |
|
515 |
443 |
$683.86 |
| 96127 |
|
291 |
236 |
$355.00 |
| 81002 |
|
79 |
68 |
$172.72 |
| 87807 |
|
16 |
13 |
$159.12 |
| 86318 |
|
14 |
12 |
$154.56 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
32 |
31 |
$131.84 |
| 90734 |
|
52 |
51 |
$0.00 |
| 90633 |
|
58 |
54 |
$0.00 |
| 90670 |
|
38 |
37 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
36 |
26 |
$0.00 |
| 90651 |
|
45 |
45 |
$0.00 |
| 90620 |
|
79 |
73 |
$0.00 |
| 90686 |
|
46 |
40 |
$0.00 |
| 90698 |
|
30 |
29 |
$0.00 |