| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,665 |
1,528 |
$87K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
929 |
921 |
$39K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
935 |
917 |
$28K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
356 |
354 |
$26K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
310 |
307 |
$21K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
205 |
203 |
$15K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
167 |
164 |
$10K |
| 99058 |
|
573 |
570 |
$9K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
742 |
737 |
$8K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
693 |
344 |
$8K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
279 |
269 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
55 |
55 |
$4K |
| 99188 |
|
288 |
288 |
$3K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
244 |
240 |
$3K |
| 83655 |
|
112 |
112 |
$1K |
| 99383 |
|
13 |
13 |
$1K |
| 90651 |
|
24 |
24 |
$382.98 |
| 85018 |
|
168 |
167 |
$349.48 |
| 92587 |
|
12 |
12 |
$178.50 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
245 |
241 |
$42.56 |
| 81003 |
|
26 |
26 |
$41.40 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
240 |
235 |
$34.35 |
| 90648 |
|
87 |
86 |
$0.00 |
| 90710 |
|
79 |
79 |
$0.00 |
| 90633 |
|
170 |
169 |
$0.00 |
| 90685 |
|
94 |
94 |
$0.00 |
| 90700 |
|
19 |
19 |
$0.00 |
| 90670 |
|
273 |
271 |
$0.00 |
| 90707 |
|
13 |
13 |
$0.00 |
| 90734 |
|
12 |
12 |
$0.00 |
| 90680 |
|
131 |
131 |
$0.00 |
| 90698 |
|
131 |
131 |
$0.00 |
| 90723 |
|
46 |
45 |
$0.00 |
| 90744 |
|
88 |
88 |
$0.00 |
| 90686 |
|
246 |
245 |
$0.00 |