| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
9,198 |
7,211 |
$693K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
9,825 |
7,834 |
$502K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,680 |
2,251 |
$168K |
| 99215 |
Prolong outpt/office vis |
1,636 |
1,238 |
$165K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
2,194 |
1,806 |
$134K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,709 |
1,350 |
$113K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,634 |
1,322 |
$104K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
2,889 |
2,499 |
$100K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
5,225 |
4,514 |
$80K |
| D0145 |
Oral evaluation for a patient under three years of age |
1,561 |
1,352 |
$39K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
3,519 |
3,028 |
$25K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,304 |
1,117 |
$22K |
| D1206 |
Topical application of fluoride varnish |
1,519 |
1,318 |
$17K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,020 |
887 |
$10K |
| 90474 |
|
627 |
553 |
$10K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
595 |
493 |
$8K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
65 |
55 |
$8K |
| 90473 |
|
548 |
433 |
$7K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
50 |
46 |
$4K |
| 96127 |
|
567 |
510 |
$3K |
| 96112 |
|
29 |
29 |
$3K |
| 99205 |
Prolong outpt/office vis |
24 |
18 |
$3K |
| 96111 |
|
30 |
30 |
$3K |
| 99384 |
|
15 |
12 |
$2K |
| 83655 |
|
133 |
129 |
$2K |
| 99383 |
|
24 |
20 |
$2K |
| 87807 |
|
146 |
120 |
$1K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
434 |
354 |
$1K |
| 0001A |
|
112 |
86 |
$1K |
| 90651 |
|
338 |
298 |
$1K |
| 99173 |
|
809 |
687 |
$591.67 |
| 90734 |
|
160 |
141 |
$500.82 |
| 0002A |
|
29 |
27 |
$455.00 |
| 92551 |
|
217 |
190 |
$360.38 |
| 81003 |
|
138 |
128 |
$307.47 |
| 84703 |
|
42 |
38 |
$287.06 |
| 90686 |
|
1,375 |
1,196 |
$199.03 |
| 90621 |
|
38 |
24 |
$143.73 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
73 |
58 |
$127.23 |
| 90671 |
|
137 |
131 |
$0.20 |
| 3008F |
|
1,778 |
1,557 |
$0.07 |
| 90680 |
|
362 |
339 |
$0.01 |
| 90670 |
|
860 |
768 |
$0.00 |
| 90633 |
|
321 |
273 |
$0.00 |
| 90672 |
|
702 |
586 |
$0.00 |
| 90649 |
|
34 |
27 |
$0.00 |
| 90685 |
|
178 |
157 |
$0.00 |
| 90700 |
|
21 |
13 |
$0.00 |
| 90715 |
|
25 |
24 |
$0.00 |
| 90710 |
|
136 |
100 |
$0.00 |
| 91300 |
|
83 |
74 |
$0.00 |
| 90648 |
|
13 |
13 |
$0.00 |
| 90723 |
|
114 |
112 |
$0.00 |
| 91301 |
|
33 |
30 |
$0.00 |
| 90619 |
|
59 |
54 |
$0.00 |
| 90688 |
|
270 |
250 |
$0.00 |
| 90647 |
|
543 |
469 |
$0.00 |
| 90698 |
|
30 |
27 |
$0.00 |
| 90696 |
|
12 |
12 |
$0.00 |
| 91307 |
|
71 |
50 |
$0.00 |